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HelpOrder Code BCRAB BCR::ABL1, p210, mRNA Detection, Reverse Transcription-PCR (RT-PCR), Quantitative, Monitoring Chronic Myeloid Leukemia (CML), Varies
Reporting Name
BCR/ABL1, p210, Quant, MonitorUseful For
Monitoring response to therapy in patients with chronic myeloid leukemia who are known to have e13/a2 or e14/a2 BCR::ABL1 fusion transcript forms
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
VariesOrdering Guidance
This test is intended for monitoring patients with known e13/a2 or e14/a2 BCR::ABL1 (p210) fusion forms.
This test should not be used to screen for BCR::ABL1 fusions at the time of diagnosis.
To screen for BCR::ABL1 fusions at the time of diagnosis, order one of the following:
-BADX / BCR::ABL1, Qualitative, Diagnostic Assay, Varies
-BCRFX / BCR::ABL1 Qualitative Diagnostic Assay with Reflex to BCR::ABL1 p190 Quantitative Assay or BCR::ABL1 p210 Quantitative Assay, Varies .
To monitor patients carrying BCR::ABL1 fusion forms coding for the p190 (e1/a2) protein, order BA190 / BCR::ABL1, p190, mRNA Detection, Reverse Transcription-PCR (RT-PCR), Quantitative, Monitoring Assay, Varies.
To monitor patients carrying rare BCR::ABL1 fusion forms coding for e19a2, e13/e14a3, e1a3, e6a2, e19a3, e8a2, e12a2, e6a3, e8a3, and e12a3, order BARQ / BCR::ABL1, Rare Fusion Monitoring, Quantitative, Varies.
If the patient has a negative history for p210 but has positive history of p190 or a rare fusion form, this test will be cancelled, and one of the following appropriate monitoring tests will be added:
-BA190 / BCR::ABL1, p190, mRNA Detection, Reverse Transcription-PCR (RT-PCR), Quantitative, Monitoring Assay, Varies
-BARQ / BCR::ABL1, Rare Fusion Monitoring, Quantitative, Varies
Shipping Instructions
Specimen must arrive within 3 days (72 hours) of collection. Collect and package specimen as close to shipping time as possible.
Necessary Information
Pertinent clinical history including if the patient has a diagnosis of chronic myeloid leukemia or other BCR::ABL1-positive neoplasm information is required.
Specimen Required
Submit only 1 of the following specimens:
Specimen Type: Whole blood
Container/Tube:
Preferred: Lavender top (EDTA)
Acceptable: Yellow top (ACD)
Specimen Volume: 10 mL
Collection Instructions:
1. Invert several times to mix blood.
2. Send whole blood specimen in original tube. Do not aliquot.
3. Label specimen as whole blood.
Specimen Type: Bone marrow
Container/Tube:
Preferred: Lavender top (EDTA)
Acceptable: Yellow top (ACD)
Specimen Volume: 3 mL
Collection Instructions:
1. Invert several times to mix bone marrow.
2. Send bone marrow specimen in original tube. Do not aliquot.
3. Label specimen as bone marrow.
Specimen Minimum Volume
Whole blood: 4 mL; Bone marrow: 1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Refrigerated (preferred) | 72 hours | PURPLE OR PINK TOP/EDTA |
| Ambient | 72 hours | PURPLE OR PINK TOP/EDTA |
Special Instructions
Reference Values
The presence or absence of BCR::ABL1 messenger RNA (mRNA) fusion form e13/e14-a2 producing the p210 fusion protein is identified. If positive, the quantitative level is reported as the normalized ratio of BCR::ABL1 (p210) to endogenous ABL1 mRNA with conversion to a percentage referenced to the international scale (IS), on which 0.1% BCR::ABL1:ABL1 (also represented on a log scale as Molecular Response 3, or MR3) is designated as a major molecular response (MMR) threshold.
Day(s) Performed
Monday through Saturday
CPT Code Information
81206
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| BCRAB | BCR/ABL1, p210, Quant, Monitor | 55135-8 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 48411 | BCR/ABL1, p210 Result | 55135-8 |
| MP003 | Specimen Type | 31208-2 |
| 19598 | Final Diagnosis: | 34574-4 |
Method Description
The assay is performed using an automated platform, GeneXpert (Cepheid). Four mL of whole blood is processed, added to an individual sample cartridge and loaded onto the GeneXpert machine. All subsequent reactions are performed within the cartridge and the results are processed and calculated by the instrument. Within the cartridge, RNA is extracted and converted to complementary DNA (cDNA).
Quantitative, reverse transcription polymerase chain reaction (PCR) is performed with a nested PCR reaction containing primers designed to amplify cDNA from the e13/a2 and e14/a2 BCR::ABL1 fusion products. A fragment of ABL1 cDNA is also amplified as a control for RNA degradation and for normalization of BCR::ABL1 results. The ratio of BCR::ABL1 (p210) to ABL1 is calculated from the difference in the crossing thresholds of BCR::ABL1 (p210) and ABL1 products in relation to a lot-specific standard curve, referenced to the international scale (IS). Lot-to-lot variation in the cartridges is corrected using a calibration calculation to reference standard curve data to the IS provided by the manufacturer.(Unpublished Mayo method)
Reject Due To
| Gross hemolysis | Reject |
| Moderately to severely clotted | Reject |
Method Name
Quantitative Reverse Transcription-Polymerase Chain Reaction (RT-PCR)
Forms
1. Hematopathology Patient Information (T676)
2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.
Testing Algorithm
For information see BCR/ABL1 Ordering Guide for Blood and Bone Marrow.