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Flow Cytometry Report

PHYSICIANPATIENTPatient: SAMPLE PATIENTDOB/Sex:MR/Chart #:

Specimen: 2 BM NA HEP, 1 BM EDTACollected: 3/5/2012Received: 3/6/2012

SAMPLE DOCTORCopies:REPORT DATE: 3/6/2012

SPECIMEN

Accession #: All Specimens: 2 BM NA HEP, 1 BM EDTA

BONE MARROW ASPIRATE, FLOW CYTOMETRIC ANALYSIS:Markedly Decreased Numbers of B-CellsSmall Population of CD19+/CD5+ B-Cells Present (See Comment)

INTERPRETATION:

Comment:CD19+/CD20- B cells account for 0.42% of the lymphocytes. Most of the B-cells consist of a population of CD19dim+/CD5dim+/CD20- cells that lack surface Ig light chain expression. These findings suggest effects of therapy(Rituximab). While the small CD19+/CD5+ population is also suggestive of persistent minimal involvement bymantle cell lymphoma, a normal B-cell subset with therapy effect cannot be entirely excluded in this very smallnumber of cells. Correlation with pending Cytogenetics and FISH studies is recommended.CD34 positive blasts account for 1.18% of total white blood cells. The granulocytes (84% of the total white bloodcells) and monocytes (3% of the total white blood cells) reveal no significant immunophenotypic abnormalities. Approximately 81% of lymphocytes are T-cells with a CD4:CD8 ratio of 1.08 (Normal 1-4). NK cells account for 0%of the total white blood cells (4% of lymphocytes). Plasma cells are not detected.

FLOW CYTOMETRY DIFFERENTIAL(% of total cells)

LYMPHOCYTES 8 B CELLS 0 T CELLS 81CD4:CD8 Ratio 1.08 Large Granular Lymphs 8 NK CELLS 4 LYMPHOSUM 86MONOCYTES 3GRANULOCYTES 84BLASTS 1.18PLASMA CELLS NegativeVIABILITY 87

ANTIBODIES ANALYZED:Antibodies used for evaluation include: CD2,3,4,5,7,8,10,11b,13,16,19,20,33,34,38,45,56,57, HLADR,kappa,la ,mbda

Mantle cell lymphoma, status post therapy.CLINICAL HISTORY:

The immunohistochemical assays were developed and their performance characteristics determined by OncoMetrix. They have not been cleared or approved by the U.S. Food and DrugAdministration. The FDA has determined that such clearance or approval is not necessary. This testing is used for clinical purposes. It should not be regarded as investigational or forresearch. This laboratory is certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) as qualified to perform high complexity clinical testing.

IDC9 Codes: 200.40 CPT Codes: 88184; 88185x22; 88189(877) 670-HEME (4363)

Dr. Douglas W. Kingma, Laboratory Director

OncoMetrix

CLIA #: 44D0915029, TN License #: 0000003284

150 Collins Street, Memphis, TN 38812Poplar Healthcare, PLLC

7-AAD

Howard L. Martin, III, M.D., Medical Director

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Flow Cytometry Report

PHYSICIANPATIENTPatient: SAMPLE PATIENTDOB/Sex:MR/Chart #:

Specimen: 2 BM NA HEP, 1 BM EDTACollected: 3/5/2012Received: 3/6/2012

SAMPLE DOCTORCopies:REPORT DATE: 3/6/2012

SPECIMEN

Accession #: All Specimens: 2 BM NA HEP, 1 BM EDTA

IMAGES:

Normal flow differential. Very small number of CD19+ B-cellspresent.

Lack of definitive surface light chainexpression on the B-cells.

Normal CD4:CD8 ratio in the T-cells. Normal myeloid immunophenotype.

Mihaela Onciu, M.D.Hematopathologist

Electronically signed3/6/2012 3:59 PM by

The immunohistochemical assays were developed and their performance characteristics determined by OncoMetrix. They have not been cleared or approved by the U.S. Food and DrugAdministration. The FDA has determined that such clearance or approval is not necessary. This testing is used for clinical purposes. It should not be regarded as investigational or forresearch. This laboratory is certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) as qualified to perform high complexity clinical testing.

IDC9 Codes: 200.40 CPT Codes: 88184; 88185x22; 88189(877) 670-HEME (4363)

Dr. Douglas W. Kingma, Laboratory Director

OncoMetrix

CLIA #: 44D0915029, TN License #: 0000003284

150 Collins Street, Memphis, TN 38812Poplar Healthcare, PLLC

Howard L. Martin, III, M.D., Medical Director