FGFR3/IgH (MM) Test
About FGFR3/IgH (MM) Test
| Field | Value |
|---|---|
| Also Known As | FGFR3/IgH FISH, t(4;14) FISH Test, IgH-FGFR3 Fusion FISH, Multiple Myeloma FISH t(4;14) |
| Sample Type | Bone marrow aspirate (preferred), peripheral blood, or FFPE tissue block |
| Fasting Required | No fasting required |
| Report Time | 3 days |
| Recommended For | Adults with suspected or confirmed multiple myeloma (MM) or monoclonal gammopathy of undetermined significance (MGUS); more common in adults over 65 years and more prevalent in men |
| Price | Starting at ₹4,920 |
What is an FGFR3/IgH (MM) Test?
The FGFR3/IgH (MM) test is a specialised genetic test that uses fluorescence in situ hybridisation (FISH) to detect an abnormal chromosomal change associated with multiple myeloma (a type of blood cancer). It looks for a specific rearrangement between chromosome 4 and chromosome 14, known as the t(4;14) translocation. This test is also referred to as the MM test or the IgH-FGFR3 Fusion FISH. The sample is usually collected from bone marrow, though peripheral blood or tissue may also be used.
What Does a FGFR3/IgH (MM) Test Measure?
This test analyses specific genes involved in the t(4;14) chromosomal translocation. The following components are examined:
| Component | What It Represents |
|---|---|
| t(4;14) translocation | An abnormal exchange of genetic material between chromosomes 4 and 14, linked to multiple myeloma |
| FGFR3 gene (chromosome 4p16.3) | A gene that normally regulates skeletal and nerve cell development is abnormally activated in this translocation |
| IGH gene (chromosome 14q32.33) | The immunoglobulin heavy chain locus, important for immune function, acts as the partner gene in this rearrangement |
| Fusion signal pattern | Normal cells show two green and two orange signals; abnormal cells show a distinct fusion pattern, indicating the translocation |
Why is an FGFR3/IgH (MM) Test Done?
Doctors order this test to confirm a diagnosis of multiple myeloma, assess disease risk, and guide treatment decisions. Below are the common reasons it is requested.
Common Symptoms That May Require This Test
A doctor may recommend this test when a patient presents with one or more of the following:
- Bone pain, particularly in the back or ribs
- Unexplained fatigue and weakness, which may be linked to anaemia
- Recurrent infections due to reduced immunity
- Elevated blood calcium levels (hypercalcaemia), causing thirst, confusion, or nausea
- Reduced kidney function (elevated creatinine)
- Unexplained weight loss
- Swelling or tenderness in localised areas due to plasmacytoma
Conditions This Test Can Help Detect
This test can support the diagnosis or assessment of the following conditions:
- Multiple myeloma (MM)
- Monoclonal gammopathy of undetermined significance (MGUS)
- Plasma cell leukaemia
- Plasmacytoma
- Smouldering multiple myeloma (SMM), for risk classification
FGFR3/IgH (MM) Test for Chronic Disease Monitoring
This test plays an important role in managing multiple myeloma over time. It helps classify patients into risk groups at the time of initial diagnosis, which guides the selection of treatment. It may also be repeated at disease progression or relapse to reassess the genetic profile of the disease.
How to Prepare and What to Expect
No special preparation is needed for this test. Here is what you should know before attending your appointment.
Do You Need to Fast?
No fasting is required for the FGFR3/IgH (MM) test. You may eat and drink normally before your appointment.
Practical Tips Before Your Test
The following tips will help ensure the sample is collected without issues:
- Bring a detailed clinical history, including your symptoms, previous test results, and family history, as this is required for the test
- Inform your doctor about all medications you are currently taking
- Wear loose, comfortable clothing that allows easy access to the hip area
- Avoid strenuous physical activity on the day of the procedure
- If you are on blood-thinning medications, inform your doctor in advance so they can advise accordingly
Step-by-Step Procedure
This test requires three types of samples: bone marrow, peripheral blood and FFPE tissue block. Here is how each is collected.
Bone marrow sample collection:
- You will be positioned lying on your side or stomach; the skin over the hip bone is cleaned, and a local anaesthetic is applied to numb the area
- A needle is gently inserted into the hip bone to draw out approximately 3 ml of bone marrow aspirate into a green-top sodium heparin tube
- The tube is inverted several times to prevent clotting, then labelled and stored at 2 to 8 degrees Celsius for transport
Peripheral blood sample collection:
- A small blood sample of approximately 3 ml is drawn from a vein in your arm using a lavender-top EDTA tube
- Both samples are sent to the laboratory, where DNA is stained with fluorescent probes that attach to the FGFR3 and IGH genes
- A specialist examines the stained samples under a fluorescence microscope, counts the signal patterns, and prepares the final report
FFPE Tissue Block:
If applicable, a formalin-fixed, paraffin-embedded (FFPE) tissue block (a preserved tissue sample from a prior biopsy) is submitted in a box. Your doctor will advise you on how to arrange this if required.
Factors That Can Affect Accuracy
The following factors may affect the reliability of the test result:
- Clotted bone marrow samples or samples older than 24 hours are not suitable for analysis
- Low plasma cell involvement in the bone marrow (less than 20%) may reduce the test's ability to detect the translocation
- Poor sample quality due to haemodilution or improper handling at the time of collection
- Technical variables in the FISH process, such as probe binding efficiency
Understanding Your FGFR3/IgH (MM) Test Results
Test results should always be reviewed with a qualified doctor who has access to your full clinical and medical history. The table below shows standard reference values used to interpret this test.
| Parameter | Normal Result | Threshold |
|---|---|---|
| t(4;14) FGFR3/IgH Fusion | Negative (no fusion detected) | Less than 5 to 7% abnormal nuclei are considered negative |
| Signal pattern in normal cells | Two green signals and two orange signals | No fusion signals present |
These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
A negative result means no translocation was detected, and chromosomal arrangement appears normal.
A positive result means the t(4;14) translocation is present, which is associated with a more aggressive form of multiple myeloma and is considered a high-risk finding that helps guide treatment planning.
Results During Special Conditions
Certain factors can influence how results are interpreted:
When plasma cell involvement in the bone marrow is below 20%, the test may be less sensitive, and a negative result should be considered alongside other clinical findings.
The t(4;14) translocation is often invisible on standard chromosome analysis and can only be reliably detected using the FISH technique. In approximately 25% of cases, the translocation is unbalanced, meaning part of chromosome 14 is lost, which may affect FGFR3 expression levels.
How to Maintain Healthy Levels
This test detects a chromosomal change that cannot be modified through lifestyle alone. However, general health maintenance supports overall well-being during diagnosis and treatment:
- Maintain a balanced diet with adequate protein, vitamins, and minerals to support immune function
- Engage in light physical activity as advised by your healthcare team to manage fatigue
- Attend all scheduled follow-up appointments with your haematologist for ongoing monitoring
Lupin Diagnostics FGFR3/IgH (MM) Test Price
The MM test cost at Lupin Diagnostics starts at ₹4,920. This test requires a visit to a Lupin Diagnostics centre; home collection is not available due to the specialised bone marrow collection procedure.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 4920 |
| CHENNAI | 4920 |
| HYDERABAD | 4920 |
| KOLKATA | 4920 |
| NAVI MUMBAI | 4920 |
| PUNE | 4920 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
The MM test online booking process at Lupin Diagnostics is straightforward:
- Select the FGFR3/IgH (MM) test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time for sample collection by a trained healthcare professional.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Frequently Asked Questions
This test detects an abnormal chromosomal rearrangement between chromosomes 4 and 14, called the t(4;14) translocation, which is linked to multiple myeloma. It helps doctors confirm the diagnosis, assess disease risk, and decide on the most appropriate treatment plan.
Bone marrow aspiration involves mild to moderate discomfort at the collection site. A local anaesthetic is applied beforehand to numb the area and reduce pain. Most patients report a brief pressure sensation during the procedure. The blood draw portion is similar to a routine venepuncture.
At Lupin Diagnostics, the report is typically delivered within 3 days. The FISH analysis requires careful examination under a fluorescence microscope, which takes time to complete accurately.
The t(4;14) translocation is cytogenetically cryptic, meaning it does not produce a visible change under standard chromosome (karyotype) analysis. The FISH technique uses fluorescent probes specifically designed to bind to the FGFR3 and IGH genes, making it the preferred and most reliable method for detecting this rearrangement.
The test is usually done once at the time of diagnosis. However, it may be repeated if the disease progresses or relapses, as the genetic profile of myeloma cells can change over time. Your haematologist will advise you based on your clinical situation.
A positive result means the t(4;14) translocation was detected. This finding is present in roughly 15% of multiple myeloma cases and is classified as a high-risk feature. It helps your doctor understand the likely course of the disease and tailor the treatment approach accordingly. A positive result should always be discussed with your specialist.
No. The FGFR3/IgH FISH test is one part of a broader diagnostic workup for multiple myeloma. It is typically used alongside other blood tests, bone marrow biopsy findings, imaging studies, and clinical assessments. A diagnosis of multiple myeloma is made by a specialist after reviewing all available information together.
FGFR3/IgH (MM) Test: Booking, Price, and Results
