BCR-ABL1 Major Quantitative Test: Booking, Price, and Results
About BCR-ABL1 Major Quantitative Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | BCR-ABL, BCR-ABL fusion, Philadelphia chromosome test, BCR-ABL1 p210 quantitative, BCR-ABL1 Transcript Detection by RT-PCR |
| Sample Type | Peripheral blood (EDTA tube) or bone marrow (sodium heparin tube) |
| Fasting Required | No fasting required |
| Report Time | 4 days |
| Recommended For | Adults and children of all genders with suspected or confirmed chronic myeloid leukaemia (CML) or Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL) |
| Price | Starting at ₹5,400 |
What is a BCR-ABL1 Major Quantitative Test?
The BCR-ABL1 major quantitative test is a specialised molecular blood test that detects and measures a specific abnormal gene fusion linked to certain blood cancers. It identifies the BCR-ABL1 p210 fusion transcript, which is present in almost all cases of chronic myeloid leukaemia (CML) and in some cases of acute lymphoblastic leukaemia (ALL). The test is also known as the Philadelphia chromosome test or BCR-ABL1 p210 quantitative test. A sample of peripheral blood or bone marrow is used.
What Does a BCR-ABL1 Major Quantitative Test Measure?
This test measures the level of the BCR-ABL1 fusion gene transcript in your blood or bone marrow. Results are reported on an International Scale (IS), which allows comparison across laboratories. The table below explains what the test tracks.
| Parameter | What It Represents |
|---|---|
| BCR-ABL1:ABL1 ratio (IS) | The proportion of abnormal BCR-ABL1 gene transcript relative to a normal reference gene, expressed as a percentage on the International Scale |
| Fusion transcript type | Detects the major (p210) form, specifically the e13a2 or e14a2 transcript variants |
| Molecular response milestones | Results are compared against defined response levels at 3, 6, and 12 months of treatment |
The BCR-ABL1 fusion produces an abnormal protein that drives uncontrolled growth of white blood cells, which is the key feature of CML.
Why is a BCR-ABL1 Major Quantitative Test Done?
This test is used both to confirm the presence of the BCR-ABL1 fusion gene and to monitor how well treatment is working over time.
Common Symptoms That May Require This Test
A doctor may request this test if you are experiencing any of the following symptoms.
- Persistent and unexplained fatigue or weakness
- Unintentional weight loss
- Recurrent or prolonged fever
- A feeling of fullness or discomfort in the abdomen, often caused by an enlarged spleen
- Anaemia (a shortage of red blood cells)
- Bone pain
- Unusual bleeding or bruising due to low platelet counts
Conditions This Test Can Help Detect
This test is relevant for a specific set of blood-related conditions. These include:
- Chronic myeloid leukaemia (CML)
- Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL)
- Very rarely, acute myeloid leukaemia (AML) or T-lymphoblastic leukaemia
- Minimal residual disease (MRD), meaning very small amounts of remaining cancer cells after treatment
BCR-ABL1 Major Quantitative Test for Chronic Disease Monitoring
Once CML or Ph+ ALL has been diagnosed, the BCR-ABL1 major quantitative test is ordered regularly, typically every 3 months, to track how the disease responds to treatment. Specific molecular response milestones at 3, 6, and 12 months guide decisions about continuing or adjusting therapy. This ongoing monitoring is a critical part of long-term disease management.
How to Prepare and What to Expect
No special preparation is needed before this test, but a few practical points are worth knowing beforehand.
Do You Need to Fast?
No fasting is required before a BCR-ABL1 major quantitative test. You can eat and drink normally before your appointment.
Practical Tips Before Your Test
The following steps will help ensure the sample is collected correctly and processed without delay.
- Bring a detailed clinical history report, including your symptoms, previous test results, and family history, as this is required for the test
- Inform your doctor or the collection staff of any current medications or ongoing treatments, including tyrosine kinase inhibitors (TKIs)
- Note the date and time of collection on the request form, as samples must arrive at the laboratory within 48 hours
- If you are being monitored over time, try to use the same laboratory for each repeat test to allow accurate comparison of results
Step-by-Step Procedure
This test requires either a peripheral blood sample or a bone marrow sample, depending on your doctor's instructions. Both procedures are described below.
Peripheral Blood Collection:
- A trained phlebotomist will clean a patch of skin on your arm with an antiseptic solution.
- A small needle is used to draw blood from a vein, typically in the crook of your arm.
- The blood is collected into a lavender-top EDTA tube (an anticoagulant tube that keeps the sample from clotting).
- The needle is removed, and a small dressing is applied to the site.
- The sample is labelled with the collection date and time, then refrigerated and dispatched to the laboratory promptly.
Bone Marrow Collection:
- This procedure is carried out at a clinical centre by a specialist doctor.
- The skin over the hip bone (or another suitable site) is cleaned, and a local anaesthetic is administered.
- A special needle is inserted into the bone marrow cavity to draw a small sample (approximately 3 ml).
- The sample is collected into a green-top sodium heparin tube.
- The site is dressed, and the sample is labelled and refrigerated for transport to the laboratory.
Both sample types are analysed using Real Time PCR (polymerase chain reaction), which detects and quantifies BCR-ABL1 transcripts.
Factors That Can Affect Accuracy
Certain conditions can affect the reliability of results. These include:
- Samples that are more than 48 to 72 hours old, as RNA in the sample degrades over time
- Severely haemolysed (broken red blood cells) or clotted samples, which are not acceptable
- Use of incorrect collection tubes (anything other than EDTA for blood or sodium heparin for bone marrow)
- Using different laboratories for serial monitoring, which can introduce variability
- Other genetic mutations present alongside the BCR-ABL1 gene, which may influence results
- The stage of the disease and overall sample quality at the time of collection
Understanding Your BCR-ABL1 Major Quantitative Test Results
Results from a BCR-ABL1 major quantitative test are expressed as a percentage on the International Scale (IS) and are compared against established response milestones. Always review your results with your treating doctor, who will interpret them in the context of your full clinical history.
| Response Level | BCR-ABL1:ABL1 (IS) Threshold | Interpretation |
|---|---|---|
| Early response (3 to 6 months) | 10% or below | Response milestone met at 3 to 6 months of treatment |
| Standard response (12 months) | 1% or below | Response milestone met at 12 months of treatment |
| Major molecular response (MMR / MR3) | 0.1% or below | Indicates remission of disease at the major molecular response level |
| Deep molecular response (MR4) | 0.01% or below | Deep response; an important milestone for patients considering stopping treatment |
| Very deep response (MR4.5) | 0.0032% or below | Very low level of detectable disease |
| Undetected | Not detected | No measurable transcript found; does not completely exclude very low-level disease |
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
At very low BCR-ABL1 levels, the precision of this test is more variable. A change in result of less than 0.5 log units (roughly a threefold difference) may not be clinically significant and should be discussed with your doctor before drawing any conclusions. Different tyrosine kinase inhibitor (TKI) treatments may also affect transcript levels differently, which your doctor will account for when reviewing your results.
How to Maintain Healthy Levels
The following general points support effective disease monitoring.
- Follow your doctor's prescribed TKI medication schedule consistently, without skipping doses.
- Attend all scheduled follow-up tests, typically every 3 months during active treatment.
- Report any new or returning symptoms such as unusual fatigue, fever, or bleeding to your doctor promptly.
Lupin Diagnostics BCR-ABL1 Major Quantitative Test Price
The BCR-ABL1 major quantitative test cost at Lupin Diagnostics starts at ₹5,400. This test requires a visit to a Lupin Diagnostics centre; home collection is not available. The table below shows indicative prices across major Indian cities.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 5400 |
| CHENNAI | 5400 |
| HYDERABAD | 5400 |
| KOLKATA | 5400 |
| NAVI MUMBAI | 5400 |
| PUNE | 5400 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Getting a BCR-ABL1 major quantitative test online booking at Lupin Diagnostics is straightforward.
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time for sample collection.
- Receive your report via email or WhatsApp within 4 days.
Frequently Asked Questions
The BCR-ABL1 major quantitative test measures the level of an abnormal gene fusion that drives certain blood cancers, primarily CML and Ph+ ALL. It is used both to confirm the presence of the BCR-ABL1 fusion transcript at diagnosis and to monitor how well treatment is working over time.
This test is recommended for patients with a confirmed or suspected diagnosis of CML or Philadelphia chromosome-positive ALL. It is also ordered regularly during treatment to track molecular response milestones at 3, 6, and 12 months.
During active treatment, monitoring every three months is standard practice. Your doctor will advise a schedule based on your treatment phase and response. The frequency may change as you reach deeper molecular response levels.
An undetected result means the BCR-ABL1 transcript was not found at measurable levels in your sample. This is a positive sign during treatment, but it does not fully rule out very low levels of disease that are below the detection limit of the test. Your doctor will explain what the result means for your specific situation.
No. The BCR-ABL1 fusion is an acquired genetic change, meaning it develops during a person's lifetime rather than being passed down through families. It is not a hereditary condition.
Different laboratories may use slightly different testing platforms, which can introduce variability in results. Using the same laboratory each time allows your doctor to compare results accurately and identify meaningful trends in your BCR-ABL1 levels.
The International Scale (IS) is a standardised system for reporting BCR-ABL1 levels that allows results from different laboratories to be compared reliably. A result of 0.1% or below on the IS indicates a major molecular response (MMR), which is a key treatment milestone for CML patients.
BCR-ABL1 Major Quantitative Test: Booking, Price, and Results
