Next Generation Sequencing in HaemOnc

PanHaemOnc NGS panel

The NE&Y GLH HaemOnc team have developed a panHaemOnc NGS panel designed to conform to NHS Englands plan to provide large panel NGS analysis in Cancer. It covers all genes on the National Test Directory (NTD), plus a number of additional genes of interest from a research or future planning perspective.

The panel was designed using Twist probes and library preparation to run on a NextSeq and has 258 genes known to be implicated in both myeloid and lymphoid disorders.

The panHaemOnc NGS panel will cover a wide range of indications on the TD and we have been working on both testing algorithms, to ensure the most appropriate samples are tested, and, to ensure the analysis is directed, but not limited.

Virtual panels have been created to ensure that appropriate gene panels are assessed for each referral, but with aim of not limiting the analysis where differential diagnoses may be considered.

The first two panels to be implemented are the acute and myeloid panel and the lymphoid panels. All genes will have been sequenced, so there remains the option of going back to specific genes on the full panel if required.

Focused Lymphoid panels

In June 2019, the lymphoid panel (liquid samples) was made available across the GLH. This panel covers genes specific to CLL, MZL and HCL, but as the Jan 2019 test directory only requests panel testing for TP53 currently, the uptake and use of this panel has remained low.

NGS RNA fusion panel

The HaemOnc Test Directory includes a number of fusion genes. Fusion NGS panels are indicated by the test directory for four disease groups, AML, ALL, Myeloma and Histiocytosis.

The GLH can deliver the Illumina Trusight RNA Fusion Panel. This panel covers 507 genes and includes at least one gene partner for the majority of HaemOnc fusions required by the Test Directory. IGH and TCR genes are not included. Although cytogenetics will continue to be offered for the majority of indications in the first instance, referral for this panel will be available for our users.

This panel is also used in to detect NTRK fusions in solid cancer – more information on the panel and how to order it can be found below.

NTRK Testing

RNA Fusion Panel Request Form