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BCR-ABL1 Transcript Detection for Chronic Myelogenous Leukemia (CML) and Acute Lymphocytic Leukemia (ALL), Quantitative

CPT 81206; 81207
Synonyms
  • Acute Lymphocytic Leukemia, BCR-ABL1 Transcript Detection by RT-PCR, Quantitative
  • Chronic Myelogenous Leukemia, BCR-ABL1 Transcript Detection by RT-PCR, Quantitative
  • Quantitative BCR-ABL1 Translocation Detection by RT-PCR for CML and ALL

Test Details

Methodology

Total RNA is isolated from the sample and subject to a real-time, reverse transcriptase polymerase chain reaction (RT-PCR). The PCR primers and probes are specific for BCR-ABL1 e13a2, e14a2 and e1a2 fusion transcripts. The ABL1 transcript is amplified as the control for cDNA quantity and quality. Serial dilutions of a validated positive control RNA with known t(9;22) BCR-ABL1 are used as reference for quantification of BCR-ABL1 relative to ABL1. The numeric BCR-ABL1 level is reported as % BCR-ABL1/ABL1 and the detection sensitivity is 4.5 log below the standard baseline (<0.0032%).

Result Turnaround Time

5 - 7 days

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Use

This assay can detect three different types of BCR-ABL1 fusion transcripts associated with CML, ALL, and AML:e13a2 (previously b2a2) and e14a2 (previously b3a2) (major breakpoint, p210), as well as e1a2 (minor breakpoint, p190). The e13a2 and e14a2 transcript values are titrated to the current International Scale (IS). The standardized baseline is 100% BCR-ABL1 (IS) and major molecular response (MMR) is equivalent to 0.1% BCR-ABL1 (IS) corresponding to a 3-log reduction. Results should be correlated with appropriate clinical and laboratory information as indicated.

Special Instructions

Please direct any questions regarding this test to oncology customer service at 800-345-4363.

Limitations

In vitro studies have indicated that this assay has an analytical detection sensitivity of 4.5 log below the standard baseline (<0.0032%). A negative result does not rule out the presence of low levels of BCR-ABL1 transcript below the level of detection of this assay, or the presence of rare BCR-ABL1 transcripts not detected by the assay.

This test was developed and its performance characteristics determined by Labcorp. It has not been cleared or approved by the Food and Drug Administration.

References

Hughes T, Branford S. Molecular monitoring of chronic myeloid leukemia. Semin Hematol. 2003 Apr; 40(2 Suppl 2):62-68.12783378
NCCN Clinical Practice Guidelines in Oncology: Chronic Myelogenous Leukemia. Version 2.2017.
White HE, Matejtschuk P, Rigsby P, et al. Establishment of the first World Health Organization International Genetic Reference Panel for quantitation of BCR-ABL mRNA. Blood. 2010 Nov 25; 116(22):e111-117.20720184

Specimen Requirements

Specimen

Whole blood, bone marrow, or cell pellet

Volume

3 to 5 mL whole blood or 1 to 2 mL bone marrow

Minimum Volume

1 mL bone marrow or 3 mL whole blood (Note: This volume does not allow for repeat testing.)

Container

Lavender-top (EDTA) tube, green-top (sodium heparin) tube, yellow-top (ACD-A) tube, tan-top (K2-EDTA) tube or pink-top (K2-EDTA) tube

Collection Instructions

Submit at room temperature. Specimens should arrive in the laboratory within 48 hours of collection. Indicate date and time of collection on test request form.

Storage Instructions

Submit at room temperature. If specimen has to be stored more than 48 hours, refrigerate at 2°C to 8°C.

Causes for Rejection

Specimen does not meet collection criteria; frozen whole blood or marrow; leaking tube; clotted blood or marrow; grossly hemolyzed; otherwise visibly degraded; contamination by another specimen; containing suspicious foreign material

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
480481 BCR-ABL1, CML/ALL, PCR, Quant 52135-1 481509 e13a2 (b2a2) transcript % 52130-2
480481 BCR-ABL1, CML/ALL, PCR, Quant 52135-1 481510 e14a2 (b3a2) transcript % 52131-0
480481 BCR-ABL1, CML/ALL, PCR, Quant 52135-1 481516 e1a2 transcript % 52132-8
480481 BCR-ABL1, CML/ALL, PCR, Quant 52135-1 480488 Interpretation: 93479-4
480481 BCR-ABL1, CML/ALL, PCR, Quant 52135-1 489031 Director Review 72486-4
480481 BCR-ABL1, CML/ALL, PCR, Quant 52135-1 481507 Background 77202-0
480481 BCR-ABL1, CML/ALL, PCR, Quant 52135-1 481508 Methodology 49549-9
480481 BCR-ABL1, CML/ALL, PCR, Quant 52135-1 484516 References 52132-8
480481 BCR-ABL1, CML/ALL, PCR, Quant 52135-1 511958 PDF 80563-0
Order Code480481
Order Code NameBCR-ABL1, CML/ALL, PCR, Quant
Order Loinc52135-1
Result Code481509
Result Code Namee13a2 (b2a2) transcript
UofM%
Result LOINC52130-2
Order Code480481
Order Code NameBCR-ABL1, CML/ALL, PCR, Quant
Order Loinc52135-1
Result Code481510
Result Code Namee14a2 (b3a2) transcript
UofM%
Result LOINC52131-0
Order Code480481
Order Code NameBCR-ABL1, CML/ALL, PCR, Quant
Order Loinc52135-1
Result Code481516
Result Code Namee1a2 transcript
UofM%
Result LOINC52132-8
Order Code480481
Order Code NameBCR-ABL1, CML/ALL, PCR, Quant
Order Loinc52135-1
Result Code480488
Result Code NameInterpretation:
UofM
Result LOINC93479-4
Order Code480481
Order Code NameBCR-ABL1, CML/ALL, PCR, Quant
Order Loinc52135-1
Result Code489031
Result Code NameDirector Review
UofM
Result LOINC72486-4
Order Code480481
Order Code NameBCR-ABL1, CML/ALL, PCR, Quant
Order Loinc52135-1
Result Code481507
Result Code NameBackground
UofM
Result LOINC77202-0
Order Code480481
Order Code NameBCR-ABL1, CML/ALL, PCR, Quant
Order Loinc52135-1
Result Code481508
Result Code NameMethodology
UofM
Result LOINC49549-9
Order Code480481
Order Code NameBCR-ABL1, CML/ALL, PCR, Quant
Order Loinc52135-1
Result Code484516
Result Code NameReferences
UofM
Result LOINC52132-8
Order Code480481
Order Code NameBCR-ABL1, CML/ALL, PCR, Quant
Order Loinc52135-1
Result Code511958
Result Code NamePDF
UofM
Result LOINC80563-0