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Flow Cytometry Report

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

Specimen: BONE MARROWCollected: 3/27/2012Received: 3/28/2012

SAMPLE DOCTORCopies:REPORT DATE: 3/28/2012

SPECIMEN

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

1. Increased Myeloid Cells2. Mild Increase in Myeloblasts with an Abnormal Immunophenotype

INTERPRETATION:

Comment:These abnormalities can be seen in a variety of myeloid neoplasms, including myeloproliferative,myeloproliferative/myelodysplastic and myelodysplastic disorders. Correlation with the CBC/Diff data andexamination of a stained bone marrow aspirate smear suggest that a myeloproliferative neoplasm is most likely inthis case.

CD34 positive blasts account for 2% of total white blood cells and have an aberrant myeloid immunophenotype.Blasts espress CD34, CD38, dim CD33, bright HLA-DR, dim CD11b, dim CD117, dim CD45, without expression ofCD13, CD56, CD7, CD2, CD16, CD14, CD41, CD64 and CD61. The viability of the specimen is 82%. Thegranulocytes (88% of the total white blood cells) and monocytes (1% of the total white blood cells) reveal nosignificant immunophenotypic abnormalities. B-cells comprise 8% of the lymphocytes and have a kappa:lambdaratio of 1.03. Approximately 78% of lymphocytes are T-cells with a CD4:CD8 ratio of 1.14 (Normal 1-4). NK cellsaccount for 1% of the total white blood cells (14% of lymphocytes). Plasma cells are not detected.

FLOW CYTOMETRY DIFFERENTIAL(% of total cells)

LYMPHOCYTES 4 B CELLS 4Kappa:Lambda Ratio 1.03 T CELLS 38CD4:CD8 Ratio 1.14 Large Granular Lymphs 5 NK CELLS 7MONOCYTES 1GRANULOCYTES 88BLASTS 2PLASMA CELLS NegativeVIABILITY 82

ANTIBODIES ANALYZED:Antibodies used for evaluation include: CD2,3,4,5,7,8,10,11b,13,16,19,20,33,34,38,45,56,57,7AAD, HLADR, kappa,lambda,14,41,61,64,117

Leukocytosis, thrombocytosis.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: 288.60, 238.71 CPT Codes: 88184; 88185x27; 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

BONE MARROW ASPIRATE:

Page 2 of 2

Flow Cytometry Report

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

Specimen: BONE MARROWCollected: 3/27/2012Received: 3/28/2012

SAMPLE DOCTORCopies:REPORT DATE: 3/28/2012

SPECIMEN

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

IMAGES:

Increased myeloid cells; smallpopulation of blasts present.

Normal myeloid immunophenotype inmaturing myeloid cells.

Normal myeloid immunophenotype inmaturing myeloid cells.

Blasts show aberrant co-expressionof CD34 and CD11b.

Polyclonal B-cells. Normal CD4:CD8 ratio.

Mihaela Onciu, M.D.Hematopathologist

Electronically signed3/28/2012 4:43 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: 288.60, 238.71 CPT Codes: 88184; 88185x27; 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