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Test Code BAKDM BCR/ABL1, Tyrosine Kinase Inhibitor Resistance, Kinase Domain Mutation Screen, Sanger Sequencing, Varies

Reporting Name

BCR/ABL1 Mutation, Sequencing

Useful For

Evaluating patients with chronic myelogenous leukemia and Philadelphia chromosome positive B-cell acute lymphoblastic leukemia receiving tyrosine kinase inhibitor (TKI) therapy, who are apparently failing treatment

 

Preferred initial test to identify the presence of acquired BCR::ABL1 mutations associated with TKI-resistance

Testing Algorithm

If BCR::ABL1 fusion type (p210, p190, p205 or p230) is not provided, the qualitative, diagnostic assay for BCR::ABL1 will be performed at an additional charge.

 

If no fusion form (p190, p205, p210, p230) is identified by qualitative testing, this test will be canceled.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Varies


Ordering Guidance


This is the preferred initial test to identify the presence of acquired BCR/ABL1 mutations associated with tyrosine kinase inhibitor (TKI)-resistance. This is the preferred initial test to identify the presence of acquired BCR::ABL1 mutations associated with tyrosine kinase inhibitor (TKI)-resistance.

 

Additional testing options are available. For ordering guidance see BCR/ABL1 Ordering Guide for Blood and Bone Marrow.



Shipping Instructions


1. Refrigerated specimens must arrive within 5 days of collection, and ambient specimens must arrive within 3 days 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 myelogenous leukemia or other BCR::ABL1-positive neoplasm is required.



Specimen Required


Submit only 1 of the following specimens:

 

Preferred:

Specimen Type: Whole blood

Container/Tube: Lavender top (EDTA)

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.

 

Acceptable:

Specimen Type: Bone marrow

Container/Tube: Lavender top (EDTA)

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.


Specimen Minimum Volume

Blood: 8 mL; Bone marrow: 2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Refrigerated (preferred) 5 days PURPLE OR PINK TOP/EDTA
  Ambient  72 hours PURPLE OR PINK TOP/EDTA

Reference Values

An interpretive report will be provided.

Day(s) Performed

Monday through Saturday

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

81170-ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase)(eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain

LOINC Code Information

Test ID Test Order Name Order LOINC Value
BAKDM BCR/ABL1 Mutation, Sequencing 55135-8

 

Result ID Test Result Name Result LOINC Value
MP004 Specimen Type 31208-2
MOFF BCRABL Fusion (210, 190, 205, 230) 55135-8
19824 Final Diagnosis: 34574-4

Method Description

Total RNA is extracted from the sample using an extraction kit. Complementary DNA is transcribed, and polymerase chain reaction (PCR) performed using primers directed against BCR and ABL1 regions to generate a long PCR product representing the translocated allele only (p210, p190, p205, or p230 transcript types) and encompassing the ABL1 region through exon 7. Second (nested) PCR amplifications are next performed to amplify the ABL1 kinase domain region using template from the first-round PCR product. Aliquots of the nested ABL1 PCR products are analyzed by Sanger sequencing and post-sequence software interpretation.(Unpublished Mayo method)

Report Available

5 to 7 days

Reject Due To

Gross hemolysis Reject
Moderately to severely clotted Reject

Method Name

Reverse Transcription Polymerase Chain Reaction (RT-PCR) with Sanger Sequencing

Secondary ID

89609

Forms

1. Hematopathology Patient Information (T676)

2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
BADX BCR/ABL1, RNA-Qual, Diagnostic Yes No