Cystic Fibrosis Foundation Mutation Analysis Program
Overview
The Mutation Analysis Program (MAP), funded by the Cystic Fibrosis Foundation and administered by The Johns Hopkins Genomics DNA Diagnostic Laboratory (JHGDDL), is a free and confidential genetic testing program for people with a confirmed or strongly suspected diagnosis of cystic fibrosis. The program provides genetic testing to people who have not yet been tested to determine their CF variants, or who have been tested previously but still have one or more unknown CF-causing variants.
By knowing their CF-causing variants, your patients can make informed decisions with you—their health care provider—about the most appropriate treatment options for them.
Forms | Test Description | Eligibility Guidelines | Enrollment Process | FAQs
Test Description
The MAP offers patients the most comprehensive clinical genetic test for CFTR that is currently available. The complete CFTR gene is sequenced (all exons and all introns along with 10 kb upstream and 5kb downstream of the gene) along with deletion/duplication analysis. Please be aware that ‘full gene’ or ‘whole gene sequencing’ of CFTR as described by other laboratories may not be equivalent to the testing provided by MAP (see below).
The JHGDDL is proud to provide patients with the advantages offered by the MAP:
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Testing is fully funded by the Cystic Fibrosis Foundation
Enrolled patients receive whole CFTR gene sequencing at no cost, except for sample collection and shipping.
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Analysis by an expert team
Complete analysis of the whole gene by a team with over 30 years’ experience interpreting variation in CFTR.
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Increased test sensitivity
Benefits individuals carrying unusual CF-causing variants such as gene rearrangements and intronic changes.
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Potential for reanalysis
As our understanding of variant effect increases, re-analysis of CFTR sequence data may yield an answer.
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Access to broader testing
Analysis of other genes known to cause elevated sweat chloride concentration (e.g. ENaC subunits and CA12) and clinical exome sequencing are also offered by the DNA Diagnostic Lab.
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Advancing CF Knowledge
De-identified variant data may be used to understand CF pathophysiology. Rare variants of unknown effect can be evaluated by the CFTR2 project to ascertain effect on CFTR function and response to FDA-approved CFTR modulators.
Eligibility Guidelines
First-Time Enrollment
- Patients must be a resident of the US.
- Patients must be referred by a physician at an accredited CF Care Center. To find an accredited CF Care Center please refer to the Cystic Fibrosis Foundation’s directory.
- Patients must have not yet had genetic testing to determine their CF variants, or have been tested previously but still have one or more unknown variants. Patients must have a confirmed or strongly suspected diagnosis of CF.
- Lowest sweat chloride levels are required for enrollment consideration. If your patient is unable to have a sweat test, please contact the JHGDDL to provide additional clinical information supporting your patient’s diagnosis.
Qualified Re-Enrollment
Individuals previously enrolled in the program who meet both the following criteria will be allowed to re-enroll for whole gene sequencing:
- MAP testing identified a single CF-causing variant.
- Lowest sweat chloride concentration is greater than 40 mmol/L.
Please note that individuals enrolled after February 15, 2021, who have already received whole gene sequencing are not eligible for re-enrollment.
Enrollment Process for Providers
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Provider submits a completed enrollment form
Complete the enrollment form, also available on the Cystic Fibrosis Foundation patient portal. Completed forms should be faxed to the lab at 410-367-3266. Please note that incomplete or outdated forms will not be accepted for consideration. -
JHGDDL reviews the enrollment and issues a decision
This process may take up to 3 business days for first time enrollments, 2-3 weeks for re-enrollments. If your patient’s enrollment is denied the JHGDDL will issue a letter detailing the reasons for denial. If you would like to appeal a denial, please contact the JHGDDL to provide additional clinical information supporting your patient’s diagnosis. The JHGDDL will perform a secondary review of your patient’s credentials and issue a final enrollment decision. -
Sample is collected from the approved individual and sent to the JHGDDL
Once you receive an approval letter for your patient, a sample can be submitted for testing. For patients approved for re-enrollment, the JHGDDL will confirm whether there is sufficient DNA remaining from prior testing. If a new sample is required, this will be communicated in the re-enrollment approval letter. If you and your patient elected to submit a saliva sample, a collection kit will be shipped to the patient. If you choose to submit a blood sample, specimens may be shipped to:
Johns Hopkins Genomics – DDL
1812 Ashland Ave.
Sample Intake; Room 245
Baltimore, MD 21205 -
JHGDDL initiates testing and releases results within 90 days
Once testing is complete, results will be faxed directly from the JHGDDL to the number provided on MAP enrollment form. Results may take up to 90 days to report.
Frequently Asked Questions
If you are unable to find the answer to your question, please contact the JHGDDL for assistance.
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The cost of the genetic testing will be covered under a grant provided by the CF Foundation. However, the patient or CF care center is responsible for the cost of the blood sample and for shipping and postage for mailing the sample to the lab.
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After your CF patient has been approved for MAP, draw a minimum of 3 ml whole blood in EDTA (lavender top) tubes. If the patient is known to have a low white blood cell count, draw at least 6 ml of blood.
Place at least two patient identifiers on the specimen tube. The Joint Commission requires that at least two identical identifiers on the specimen tube appear on the accompanying paperwork. Patient identifiers can be name, date of birth, medical record number, or sample accession number. Samples without proper identifiers cannot be processed by the laboratory as received, and failure to include identifiers will significantly delay processing time, if not preclude testing of the sample.
If the blood sample is expected to arrive in the within 36 hours of draw, the sample can stay ambient (room temperature). If the blood needs to be stored before shipping, refrigerate the sample and ship it with a cold pack. Refrigerated blood samples are stable for 1 week. Do not freeze the blood sample.
Please note:- The JHGDDL cannot accept deliveries on Saturday. Please schedule shipments for delivery to the lab between Monday-Friday.
- All patients MUST have an authorization number before the blood and paperwork are sent to the laboratory. Any unapproved sample received without an assigned authorization number will be discarded without review of the application.
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Patients may get their blood drawn at their care center lab, if available. Otherwise, it is at the provider's and patient's discretion to use a lab that is most convenient and affordable.
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Patients who elect to submit a saliva sample will be sent a specimen collection kit with instructions explaining how to collect a sample from the JHGDDL. The collection kit will be shipped to the patient’s address as written on the enrollment form. The patient is responsible for ensuring the specimen is returned to the lab using the return label provided in the kit.
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If the patient is from the state of New York, the ordering provider is required to complete and submit the New York State Non-Permitted Laboratory Test Request Approval Form to the New York State Department of Health Clinical Laboratory Evaluation Program (CLEP) for approval. This request must be completed by the ordering provider and the approval shared with the JHGDDL before testing can begin.
Please send non-permitted lab test request forms to the following CLEP program:
Genetic Testing Quality Assurance Program
Wadsworth Center, NYSDOH
Phone: 518-474-6271
Fax: 518-486-2693 -
No, patients' names and corresponding test results will not be released to the public. Test results will be released only to the referring doctor or CF care center.
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In order to allocate funds in the most efficient way, testing occurs in batches. It can take up to 90 days to receive results.
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Individuals previously enrolled in the program who meet both the following criteria will be allowed to re-enroll for whole gene sequencing:
- MAP testing identified a single CF-causing variant.
- Lowest sweat chloride concentration is greater than 40 mmol/L.
Patients enrolled after February 15, 2021, who have already received whole gene sequencing are not eligible.
To re-enroll your patient, please complete the enrollment form and fax it to the lab at 410-367-3266.