Days Set Up
Monday - Friday
Analytic Time

2 - 7 days

MiChart Code
BCR/ABL by PCR, Quantitative
Soft Order Code
QBCR

Test Updated:

Synonyms

BCRABL Quantitation by PCR
BCRID
Break Point Cluster Region (bcr) Assay
Breakpoint Cluster Region (bcr) Analysis
LAP Score
t(9;22) Translocation
BCR/ABL BREAKPOINT ID ANALYSIS
LAPA
QBCR
LEUKOCYTE ALKALINE PHOSPHATASE
BCR/ABL QUANTITATIVE ANALYSIS
MLABEL
BCR/ABL Breakpoint ID Analysis
BCRIDS

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Test Overview

Test Methodology

Reverse transcription followed by Real-Time Polymerase Chain Reaction (PCR).

Test Usage

The t(9;22) chromosomal translocation is a hallmark of chronic myelogenous leukemia (CML) and occurs in a proportion of acute lymphocytic leukemias (ALL). At the molecular level, it creates a chimeric gene on the derivative chromosome 22 that is comprised of the promoter and 5’ region of the BCR gene (22q11) fused to the 3’ region of the ABL1 gene (9q34). Transcription of this fusion gene, which is under the control of the ubiquitously active BCR promoter, results in a BCR/ABL1 chimeric oncoprotein that is critical for malignant transformation. Depending upon the location of the BCR and ABL1 gene breakpoints, the resulting chimeric fusion transcript can assume one of several forms, including the b2a2 and b3a2 forms, which both encode a p210 protein (>95% of CML cases, approximately 50% of adult ALL cases, approximately 10% of pediatric ALL cases), the e1a2 form, which encodes the p190 protein (2-3% of CML cases, 50% of ALL cases, approximately 90% of pediatric ALL cases), or an e19a2 form which encodes the p230 protein form (very rare). This test can detect and quantify both the p210 (b2a2, b3a2) and p190 (e1a2) transcripts by reverse transcription real-time PCR (RT-qPCR) for diagnosis and monitoring of CML and ALL. The type of transcript will be reported (p210 or p190). Results for the p210 transcript are reported on the International Scale (IS) and with Molecular Reduction (MR) value. Result for the p190 transcript are reported as a ratio of %BCR/ABL1:ABL1. The limit of quantification for p210 is 0.002%IS (MR4.7) and p190 is 0.0025%. Please note that both tests (p210 and p190) will be performed until a transcript is detected. Subsequent testing on the same patient will be limited to the transcript previously identified.

Reference Range

Interpretive report provided.

* Reference ranges may change over time. Please refer to the original patient report when evaluating results.

Specimen Requirements

Collection Onsite

Michigan Medicine Hospitals Only: Collect blood or bone marrow in a lavender top tube. Refrigerate and send intact blood or bone marrow specimen within 48 hours of collection. Fresh tissue (preferably 0.5cm3, sent in RPMI) and fresh aspirates or body fluids are acceptable. Refrigerate and send, preferably within 24 hours. Frozen tissue specimens – preferably frozen with 1 hour of collection – may also be sent frozen on dry ice. Fresh cell suspensions in RPMI should be refrigerated and sent, preferably within 48 hours. Frozen cell suspensions – preferably frozen with 1 hour of collection – may also be sent frozen on dry ice.

Collection Offsite

Collect blood or bone marrow in a lavender top tube. Refrigerate and send intact blood or bone marrow specimen within 48 hours of collection. Fresh tissue (preferably 0.5cm3, sent in RPMI) and fresh aspirates or body fluids are acceptable. Refrigerate and send, preferably within 24 hours. Frozen tissue specimens – preferably frozen with 1 hour of collection – may also be sent frozen on dry ice. Fresh cell suspensions in RPMI should be refrigerated and sent, preferably within 48 hours. Frozen cell suspensions – preferably frozen with 1 hour of collection – may also be sent frozen on dry ice.

Lavender Top Tube
Normal Volume
5 mL EDTA (lavender) whole blood; 3 mL EDTA (lavender) bone marrow; Fresh/frozen tissue and fresh aspirates or body fluids; Fresh/frozen cells in RPMI.
Extracted RNA is also acceptable if extracted in a CLIA certified laboratory.

Minimum Volume
 

Billing Information

CPT Code
81206, 81207
Pro Fee Code
 
LOINC
21821-4

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Our High Standard

Quality that sets us apart

As the reference laboratory division of Michigan Medicine's Department of Pathology, MLabs shares the institution's commitment to applying established quality principles to clinical laboratory testing. Like other large organizations in complex, consequential fields, we rely on an established approach to monitor quality throughout the testing process.