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t(9;22)(q34;q11.2);BCR-ABL1, Quantitative Transcript Analysis

t(9;22)(q34;q11.2);BCR-ABL1 Analysis by PCR


Real-Time (Quantitative), Nested PCR (Qualitative)

Indication

Detection of the t(9;22)(q34;q11.2);BCR-ABL1 fusion transcript for diagnosis and monitoring of residual disease in patients with chronic myelogenous leukemia (CML), B-lymphoblastic leukemia (B-ALL) with t(9;22) and a small subset of patients with acute myeloid leukemia  (AML).

Methodology

RNA is extracted from white blood cells in bone marrow and/or peripheral blood and reverse transcribed to cDNA. Real-time PCR is performed to amplify the BCR-ABL1 fusion transcripts as well as ABL1 transcripts. Common transcript types also known as major (e13a2 (b2a2), e14a2 (b2a2)) and minor (e1a2) are detected in single tube reaction by real-time Quantitative PCR.  When an Alternate transcript (e13a3 (b2a3), e14a3 (b3a3) and e19a3) is suspected, a qualitative nested PCR is performed, followed by capillary electrophoresis and Sanger sequencing for identification of fusion transcript.

Test Parameters

Sensitivity is approximately 1 in 100,000 for real-time PCR and 1in 100,000 for qualitative nested PCR.  Levels detected in peripheral blood and bone marrow samples are generally equivalent.

Turnaround Time

5-10 working days (Quantitative); 5-15 working days (Qualitative).

Sample Requirements

• 10-30 ml peripheral blood in lavender top (EDTA) tube, sent on wet ice
or
• 2-5 ml of bone marrow aspirate in lavender top (EDTA) tube, sent on wet ice

CPT Codes

81206, 81207, 81208
The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.


© 2014 The University of Texas MD Anderson Cancer Center