PATHWAY OPTIONS
There are a number of choices. Please make sure you select the correct pathway for your sample. Please give as much clinical detail as possible for all samples.
Pathway 10A: Eosinophilia assessment (blood)
Use if eosinophils persistently >1.5×109 or systemic symptoms, and a cause is not clearly present. Genetics panel testing sensitivity requires 5% of tested cells to be eosinophils. Note that this pathway looks for myeloid mutation associated with eosinophilia and will not look for alternative reactive or neoplastic causes, if these are suspected please use the second marrow option below.
The following tests will be performed:
- Blood morphology
- FISH (eosinophilia investigation- will include FIP1L1-PDGFRA)
- Molecular myeloid panel
- Molecular RNA blood hold sample
Pathway 10B: Eosinophilia assessment (marrow)
This test set is recommended in complex cases, specifically to look for infiltration causing a reactive eosinophilia. Molecular testing will be used to look for alternative clonal clonal cause for eosinophilia. The flow cytometry sample will initially be processed for a myeloid panel, but a population check will be performed and will proceed to lymphoid subsets or numbers are abnormal.
The following tests will be performed:
- Morphology marrow
- Flow cytometry (eosinophilia)
- Bone marrow trephine
- FISH (FIP1L1-PDGFRA)
- Molecular DNA (process sample as indicated by findings)
- Molecular RNA (process sample as indicated by findings)