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HelpOrder Code BCRFX BCR/ABL1 Qualitative Diagnostic Assay with Reflex to BCR/ABL1 p190 Quantitative Assay or BCR/ABL1 p210 Quantitative Assay, Varies
Ordering Guidance
Additional testing options are available. For ordering guidance see BCR/ABL1 Ordering Guide for Blood and Bone Marrow.
Shipping Instructions
1. Specimen must arrive within 72 hours of collection.
2. 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/myelogenous leukemia or other BCR/ABL1 positive neoplasm 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 blood.
Specimen Type: Bone marrow
Container/Tube:
Preferred: Lavender top (EDTA)
Acceptable: Yellow top (ACD)
Specimen Volume: 4 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.
Forms
1. Hematopathology Patient Information (T676)
2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.
Useful For
Diagnostic workup of patients with high probability of BCR::ABL1-positive hematopoietic neoplasms, predominantly chronic myeloid/myelogenous leukemia and acute lymphoblastic leukemia
Testing Algorithm
When a positive common p210 or p190 BCR::ABL1 result is identified by the qualitative assay, a reflex test will then be performed at an additional charge to determine the quantitative transcript level of BCR::ABL1 messenger RNA. A positive common p210 or p190 result will specifically trigger either quantitative p210 or p190 testing to provide a normalized percentage of transcript level. For the p210 target, the value is additionally defined using the international scale convention. The results are released in an integrated report and provide a baseline quantitative transcript to monitor treatment response. If the initial qualitative testing is negative, or an alternate rare form of BCR::ABL1 is detected, then no reflex testing will be pursued, and the initial results will be reported.
For more information see:
-Myeloproliferative Neoplasm: A Diagnostic Approach to Bone Marrow Evaluation
-Myeloproliferative Neoplasm: A Diagnostic Approach to Peripheral Blood Evaluation
Special Instructions
Method Name
Reverse Transcription Polymerase Chain Reaction (RT-PCR) Multiplex PCR
Reporting Name
BCR/ABL1 Reflex, Qual/QuantSpecimen Type
VariesSpecimen Minimum Volume
Blood: 8 mL; Bone marrow: 2 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 |
Reject Due To
| Gross hemolysis | Reject |
| Moderately to severely clotted | Reject |
Reference Values
An interpretive report will be provided.
Method Description
Total RNA is extracted from the patient's blood or bone marrow at the time of diagnosis and messenger RNA (mRNA) is reverse transcribed into complementary DNA (cDNA). The cDNA is then subjected to polymerase chain reaction (PCR) using 4 separate multiplex reactions. A qualitative result, which will include the relative ratio of target translocation mRNA to control GUSB gene mRNA, will be given by LightCycler 96 software. As this method employs a quantitative PCR platform, the results can be used to evaluate the relative expression levels of the translocation mRNA relative to control mRNA, thus providing an improved measure of RNA quality in the assay. Reporting of results will be qualitative; either BCR::ABL1 mRNA positive/detected (with transcript type) or negative/not detected.(Unpublished Mayo method)
Day(s) Performed
Monday through Saturday
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
81206
81207
81208
81479 (if appropriate for government payers)
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| B190R | BCR/ABL1, p190, Quant, Reflex | Yes, (order BA190) (Bill Only) | No |
| B210R | BCR/ABL1, p210, Quant, Reflex | Yes, (order BCRAB) (Bill Only) | No |