1q21 and 1p32 [Multiple Myeloma] Test
About 1q21 and 1p32 [Multiple Myeloma] Test
| Field | Value |
|---|---|
| Also Known As | 1q21/1p32 FISH Test, Chromosome 1 Abnormalities FISH Test, CKS1B/CDKN2C FISH Test, Myeloma Cytogenetics Panel (1q/1p) Test |
| Sample Type | Bone marrow, peripheral blood, or FFPE tissue block |
| Fasting Required | No fasting required |
| Report Time | 9 days |
| Recommended For | Adults diagnosed with or suspected of having multiple myeloma or related plasma cell disorders |
| Price | Starting at ₹4,800 |
What is a 1q21 and 1p32 [Multiple Myeloma] Test?
The 1q21 and 1p32 [Multiple Myeloma] test is a specialised genetic test that detects specific chromosomal abnormalities in plasma cells. It uses a technique called fluorescence in situ hybridisation (FISH), which uses fluorescently labelled DNA probes to identify changes on chromosome 1.
Doctors order this test for patients diagnosed with or suspected of having multiple myeloma, a cancer of plasma cells in the bone marrow. It is also known as the 1q21/1p32 FISH test and the Myeloma Cytogenetics Panel (1q/1p) test.
What Does a 1q21 and 1p32 [Multiple Myeloma] Test Measure?
This test analyses two specific regions on chromosome 1 in myeloma cells. The findings help doctors understand how aggressive the disease may be. The two regions examined are the following:
| Region | Gene Targeted | What Is Detected |
|---|---|---|
| 1q21 | CKS1B | Gain (one extra copy, 3 total) or amplification (two or more extra copies, 4 or more total) |
| 1p32 | CDKN2C | Deletion (one or both copies of this tumour suppressor gene are missing) |
The 1q21 region plays a role in cell cycle progression and myeloma cell survival. Extra copies in this region are among the most common secondary genetic changes seen in multiple myeloma. The 1p32 region contains a tumour suppressor gene, meaning it normally helps prevent uncontrolled cell growth. When this gene is deleted, plasma cells can divide at a faster rate.
Why is a 1q21 and 1p32 [Multiple Myeloma] Test Done?
This test is ordered to assess genetic risk in patients with multiple myeloma or related plasma cell disorders. Below are the key reasons a doctor may request it.
Common Symptoms That May Require This Test
Doctors may request this test when a patient presents with symptoms that suggest multiple myeloma. These symptoms include:
- Persistent bone pain, often in the back, chest, pelvis, or upper legs
- Fatigue and weakness linked to anemia (low red blood cell count)
- Frequent or recurring infections
- Symptoms of high calcium in the blood, such as increased thirst, confusion, or drowsiness
- Numbness or weakness in the limbs
Conditions This Test Can Help Detect
This test is used alongside other assessments for the following purposes:
- Identifying gain or amplification of chromosome 1q21
- Detecting deletion of 1p32
- Risk stratification for newly diagnosed multiple myeloma
- Prognosis assessment to guide the intensity of treatment
1q21 and 1p32 [Multiple Myeloma] Test for Chronic Disease Monitoring
This test is not a one-time assessment. It may be repeated at the time of disease relapse to reassess the cytogenetic risk profile and inform treatment decisions. The amplification of 1q21 is seen in approximately 40% of newly diagnosed patients and rises to around 70% in relapsed or treatment-resistant myeloma. Guidelines recommend repeating FISH testing at relapse, as the genetic profile of the disease can change over time.
How to Prepare and What to Expect
No complex preparation is needed for this test. The steps below cover what you should know before your appointment.
Do You Need to Fast?
No, fasting is not required. You can eat and drink normally before the test. No special dietary changes are necessary in the hours leading up to sample collection.
Practical Tips Before Your Test
Preparing for this test involves a few practical steps. Keep the following in mind:
- Bring a detailed clinical history, including your symptoms, previous test results, and any relevant medical records
- Inform your doctor about all medications you are taking, particularly blood thinners, before the bone marrow procedure
- Arrange for someone to accompany you home if sedation is used during the procedure
- Wear comfortable, loose-fitting clothing that allows easy access to the hip area
- Discuss any concerns about the procedure with your doctor beforehand
Step-by-Step Procedure
The 1q21 and 1p32 [Multiple Myeloma] test procedure involves collecting a bone marrow, peripheral blood, or FFPE tissue sample. Here is what to expect:
Bone Marrow Sample Collection:
- The procedure is typically performed on the back of the hip bone under local anesthesia to minimise discomfort.
- A trained specialist uses a needle to withdraw a small liquid sample of bone marrow (aspiration). In some cases, a small piece of solid bone marrow tissue is also taken.
- The bone marrow sample is collected into a sodium heparin (green-top) tube. A peripheral blood sample may be collected in an EDTA (lavender-top) tube as an alternative or supplement.
- The sample is stored at 2 to 8 degrees Celsius and transported to the laboratory, ideally within 24 hours of collection and no later than 72 hours.
- In the laboratory, plasma cells are isolated, and FISH analysis is performed using specific probes targeting the 1q21 and 1p32 regions of chromosome 1.
- Results are prepared and dispatched within the specified report turnaround time.
Factors That Can Affect Accuracy
Certain factors may influence the quality or interpretation of results. These include:
- An insufficient number of plasma cells in the sample
- Poor sample quality or improper anticoagulation of the collected specimen
- Delayed transport or incorrect storage temperature (the sample must not be frozen)
- Clonal heterogeneity, where multiple cell populations with differing genetic changes are present in the same sample
Understanding Your 1q21 and 1p32 [Multiple Myeloma] Test Results
Results from this test should always be reviewed with a hematologist (a blood and bone marrow specialist). The table below outlines what normal and abnormal findings typically indicate.
| Parameter | Normal Finding | Abnormal Finding |
|---|---|---|
| 1q21 (CKS1B) | 2 copies detected, no gain or amplification | 3 copies = gain; 4 or more copies = amplification |
| 1p32 (CDKN2C) | 2 copies detected, no deletion | 1 copy = partial deletion; 0 copies = complete deletion |
Disclaimer: These findings are intended as a general guide. Interpretation of FISH results should always be performed by a qualified hematologist in the context of the patient's overall clinical and laboratory profile.
Results During Special Conditions
Certain circumstances can affect how results are interpreted. Your doctor will take the following into account:
- The standard cut-off for classifying a sample as positive for 1q21 gain or amplification is 20%, as recommended by the European Myeloma Network. Smaller proportions of abnormal cells may still carry prognostic significance.
- Patients with 1q21 gain or amplification are more likely to also have a 1p32 deletion. In fact, 1p32 deletion is associated with 1q21 gains in a large majority of cases, so both findings are often assessed together.
Disease Monitoring and Management
This test measures genetic changes in cancer cells rather than modifiable health markers, so the focus is on monitoring and overall well-being. General guidance includes:
- Attend all scheduled follow-up appointments with your haematologist for ongoing disease monitoring
- Maintain balanced nutrition and engage in appropriate physical activity as tolerated and advised by your care team
- Speak with your doctor about any new or changing symptoms between appointments
Lupin Diagnostics 1q21 and 1p32 [Multiple Myeloma] Test Price
The 1q21 and 1p32 [Multiple Myeloma] test cost at Lupin Diagnostics starts at ₹4,800. This test requires a visit to a Lupin Diagnostics centre, as home collection is not available for this test. Depending on the sample type requested, collection or submission may require a visit to a clinical facility or Lupin Diagnostics centre.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 4800 |
| CHENNAI | 4800 |
| HYDERABAD | 4800 |
| KOLKATA | 4800 |
| NAVI MUMBAI | 4800 |
| PUNE | 4800 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Booking the 1q21 and 1p32 [Multiple Myeloma] test online is straightforward. Follow these steps:
- Select the test on the Lupin Diagnostics website
- Choose your city and preferred centre location
- Visit the centre at your scheduled time and follow the instructions provided for sample collection or submission
- Receive your report via email or WhatsApp within the stipulated turnaround time
Frequently Asked Questions
This test detects specific chromosomal changes in myeloma cells: extra copies at the 1q21 region and missing genetic material at the 1p32 region. Doctors use the findings to assess disease risk, classify prognosis, and guide treatment decisions for patients with multiple myeloma.
The preferred sample is often bone marrow aspirate, although peripheral blood or an FFPE tissue block may be accepted in specific clinical situations. A specialist inserts a needle into the back of the hip bone under local anesthesia to withdraw a small liquid marrow sample. In some cases, a peripheral blood sample or FFPE tissue block may also be used.
No fasting or special preparation is required before this test. You should inform your doctor about any medications you are taking, especially blood thinners, and bring a detailed clinical history, including your symptoms and previous test results.
An abnormal result indicates the presence of specific chromosomal changes that are associated with a higher-risk disease profile. Patients with 1q21 amplification are generally classified as high risk, and biallelic deletion of 1p32 is linked to a particularly poor outlook. Your haematologist will interpret the results alongside all other clinical information.
No. The 1q21 and 1p32 [Multiple Myeloma] test home collection is not available because the primary sample requires bone marrow aspiration, which must be performed by a trained specialist in a clinical or hospital setting.
This test is recommended at the time of initial diagnosis. It may be repeated at disease relapse, as the genetic profile of myeloma can change over time. Your hematologist will advise you on the appropriate timing based on your individual situation.
No. This test does not diagnose multiple myeloma by itself. It is used in patients who are already diagnosed with or strongly suspected of having the condition. The results help classify the severity and genetic risk profile of the disease to support treatment planning.
1q21 and 1p32 [Multiple Myeloma] Test
