Fluorescence In Situ Hybridization

Fluorescent probes to detect the BCR-ABL translocation have become widely available and are equally suitable for analysis of metaphases and interphases [Figure 17.1(c)]. Using FISH on metaphase spreads allows for analysis of several hundred cells, which increases the sensitivity for detection of residual disease by one order of magnitude.18 Analysis of interphase nuclei permits making a diagnosis of CML in cases that fail to grow metaphases. FISH on interphase nuclei from the peripheral blood correlates with bone marrow cytogenetics.19 However, the fact that the Ph status of B cells is unpredictable can lead to over- or underestimation, when unselected peripheral blood white cells are analyzed.20 For diagnostic purposes, it

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