ALL Panel Deletion/Duplication Detection Test
About ALL Panel Deletion/Duplication Detection Test
| Field | Value |
|---|---|
| Also Known As | ALL MLPA Panel, ALL Copy Number Variation Panel, ALL Del/Dup Detection, B-ALL/T-ALL Deletion Duplication Panel |
| Sample Type | Bone marrow aspirate (preferred) or peripheral blood |
| Fasting Required | No |
| Report Time | 15 Days |
| Recommended For | Children and adults with suspected or confirmed Acute Lymphoblastic Leukaemia (ALL) |
| Price | Starting at ₹10,800 |
What is an ALL Panel Deletion/Duplication Detection Test?
The ALL Panel Deletion/Duplication Detection Test is a specialised genetic test that identifies missing or extra copies of key genes linked to Acute Lymphoblastic Leukaemia (ALL), a cancer of the blood and bone marrow. It uses a technology called MLPA (Multiplex Ligation-dependent Probe Amplification) to examine multiple gene regions in a single analysis. The test is ordered at the time of ALL diagnosis and may be repeated at relapse. Also referred to as the ALL MLPA Panel or ALL Del/Dup Detection, it is an important tool for understanding how a patient's leukaemia is likely to behave.
What Does an ALL Panel Deletion/Duplication Detection Test Measure?
This test checks for deletions (missing gene segments) or duplications (extra gene copies) across several genes known to influence ALL behaviour and treatment outcome. The genes examined include:
| Gene | What It Does |
|---|---|
| IKZF1 | Encodes the IKAROS protein, which is essential for lymphoid cell development; deletions indicate poor prognosis |
| CDKN2A/CDKN2B | Tumour suppressor genes that control cell division; deletions are linked to adverse outcomes |
| PAX5 | A transcription factor critical for B-cell development |
| ETV6 | Frequently deleted in ALL; also involved in gene fusions |
| EBF1 | Required for early B-lymphocyte development |
| BTG1 | Involved in cell cycle regulation and programmed cell death |
| RB1 | A tumour suppressor gene that controls cell division |
| ERG | A transcription factor; deletions may affect prognosis alongside IKZF1 deletions |
| PAR1 Region | A region on sex chromosomes used in risk classification |
Why is an ALL Panel Deletion/Duplication Detection Test Done?
This test is ordered when a doctor needs to understand the genetic makeup of a patient's leukaemia to guide treatment decisions accurately.
Common Symptoms That May Require This Test
A doctor may order this test when a patient presents with the following symptoms, which are associated with ALL:
- Extreme tiredness or fatigue that does not improve with rest
- Frequent infections due to a weakened immune system
- Unexplained bruising or bleeding from the gums or nose
- Breathlessness or dizziness
- Unintended weight loss
- Heavy or prolonged menstrual periods
- Bone or joint pain
Conditions This Test Can Help Detect
The ALL Panel Deletion/Duplication Detection Test helps identify key genetic findings that influence clinical decisions:
- Risk stratification in newly diagnosed ALL (identifying high-risk versus standard-risk disease)
- IKZF1plus profile, where IKZF1 deletion occurs alongside CDKN2A/B, PAX5, or PAR1 deletions — associated with very poor prognosis
- High-risk genetic subtypes that may require intensified treatment
- Patients who may benefit from allogeneic stem cell transplantation
- Clonal evolution at relapse, where new genetic changes develop over time
ALL Panel Deletion/Duplication Detection Test for Chronic Disease Monitoring
This test plays a role beyond initial diagnosis. After treatment begins, it may be repeated at relapse to detect new genetic abnormalities and guide decisions about changing therapy. It helps haematologists assess whether treatment intensification or a stem cell transplant may be appropriate based on the evolving genetic profile.
How to Prepare and What to Expect
Preparing for this test is straightforward, but the sample collection process requires a visit to a clinical centre.
Do You Need to Fast?
No fasting is required before this test. You may eat and drink normally on the day of the appointment.
Practical Tips Before Your Test
Before attending your appointment, keep the following in mind:
- Bring a detailed clinical history report, including your symptoms, previous test results, and relevant medical records, as this is required for the test
- Inform your doctor about all current medications, particularly blood thinners, before the procedure
- Peripheral blood may be used as an alternative sample only if it contains sufficient blast cells (abnormal leukaemia cells)
- The test is typically ordered at the time of ALL diagnosis and may be repeated at relapse
- Ensure prompt transport of the sample to the laboratory after collection
Step-by-Step Procedure
This test requires two sample types: a bone marrow aspirate and a peripheral blood sample. Both may be collected during the same clinical appointment.
Bone Marrow Sample Collection:
- The doctor will ask you to lie on your side or stomach. The most common collection site is the back of the hip bone (iliac crest).
- The skin and bone surface are numbed using local anaesthesia or IV sedation to minimise discomfort.
- A specialist inserts a hollow needle into the bone and withdraws a small amount of bone marrow. The entire process typically takes around 10 minutes.
- A small dressing is applied to the site after the procedure.
Peripheral Blood Sample Collection:
- A trained phlebotomist draws 3 ml of blood from a vein in your arm into a lavender-top EDTA tube.
- Both samples are labelled, stored at 2 to 8 degrees Celsius, and sent to the laboratory, where DNA is extracted and analysed using MLPA technology.
Factors That Can Affect Accuracy
Several factors can influence the quality and reliability of results:
- Low blast cell percentage in the sample, which may reduce test sensitivity
- Prior chemotherapy or treatment, which can alter the genetic profile of the sample
- Delay in sample transport or improper storage
- Poor DNA quality or insufficient DNA quantity extracted from the sample
- Presence of multiple leukaemic cell populations (clonal heterogeneity), which may complicate interpretation
Understanding Your ALL Panel Deletion/Duplication Detection Test Results
Results from this test are interpreted by a specialist in the context of your clinical history, other diagnostic findings, and overall health status. The table below shows general interpretation guidelines.
| Finding | Copy Number Ratio | Interpretation |
|---|---|---|
| Normal (no alteration) | Within normal limits | No deletion or duplication detected in the genes analysed |
| Deletion detected | Less than 0.75 | One or both copies of the gene are missing |
| Duplication detected | Greater than 1.25 | Extra copies of the gene are present |
Disclaimer: These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Certain conditions can affect how results are read:
- If the sample contains a low proportion of blast cells, the test may not detect all genetic changes present.
- Samples collected after chemotherapy has begun may show an altered genetic profile that does not reflect the original disease characteristics.
- When multiple leukaemic cell populations are present, some genetic alterations may occur at lower frequencies, complicating interpretation.
How to Maintain Healthy Levels
Because this test detects cancer-related genetic changes rather than lifestyle-influenced markers, its results are not modifiable through diet or exercise. However, general steps that support overall well-being during treatment include:
- Attending all scheduled follow-up appointments with your haematologist or oncologist
- Reporting any new or worsening symptoms to your doctor promptly
- Maintaining good nutrition and staying well-hydrated, as guided by your care team
Lupin Diagnostics ALL Panel Deletion/Duplication Detection Test Price
The ALL Panel Deletion/Duplication Detection Test is priced starting at ₹10,800 at Lupin Diagnostics. As this test requires bone marrow aspiration, it must be performed at a Lupin Diagnostics centre by a qualified specialist. Home collection is not available for this test.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 10800 |
| CHENNAI | 10800 |
| HYDERABAD | 10800 |
| KOLKATA | 10800 |
| NAVI MUMBAI | 10800 |
| PUNE | 10800 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Follow these steps to schedule your test:
- Select the ALL Panel Deletion/Duplication Detection Test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time to have a sample collected by a trained specialist.
- Receive your report via email or WhatsApp within 15 days.
Frequently Asked Questions
The ALL Panel Deletion/Duplication Detection Test is a genetic test that uses MLPA technology to identify missing or extra gene copies in key regions associated with Acute Lymphoblastic Leukaemia. It helps doctors classify disease risk and make informed treatment decisions. It is performed on bone marrow or peripheral blood samples.
Certain gene deletions, particularly in IKZF1, are strongly associated with an increased risk of treatment failure. Identifying these changes at diagnosis allows doctors to tailor treatment intensity accordingly. The ALL MLPA Panel also helps determine whether a stem cell transplant may be needed.
Two samples are required: a bone marrow aspirate (collected from the hip bone) and a peripheral blood sample drawn into an EDTA tube. Bone marrow is the preferred sample, as it more reliably reflects the leukaemic cell population.
Results for the ALL Panel Deletion/Duplication Detection Test are typically delivered within 15 days. This allows time for DNA extraction, MLPA analysis, and specialist reporting.
Yes. Clinical history is required for this test. Please bring documentation of your symptoms, previous diagnostic results, and any relevant medical records when you visit the centre.
Yes. While the test is primarily ordered at diagnosis for risk stratification, it may be repeated at relapse. This helps detect new genetic changes that could influence decisions about adjusting treatment or pursuing stem cell transplantation.
No. The preferred sample for the ALL Del/Dup Detection test is bone marrow aspirate, which must be collected by a specialist in a clinical setting. This procedure cannot be performed at home, so a centre visit is necessary.
ALL Panel Deletion/Duplication Detection Test
