E2A (TCF3) Gene Rearrangement Test: Booking, Price, and Results
About E2A (TCF3) Gene Rearrangement Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | TCF3 rearrangement test, E2A gene rearrangement, E2A-PBX1 fusion test, E2A translocation test, Transcription Factor 3 rearrangement |
| Sample Type | Bone marrow (sodium heparin tube) and peripheral blood (EDTA tube) |
| Fasting Required | No fasting required |
| Report Time | 10 days |
| Recommended For | Children and adults with suspected B-cell acute lymphoblastic leukaemia; primarily paediatric patients aged 1 to 16 years |
| Price | Starting at ₹5,000 |
What Is an E2A (TCF3) Gene Rearrangement Test?
The E2A (TCF3) gene rearrangement test is a specialised genetic test that checks for abnormal changes in the TCF3 gene, also known as the E2A gene. This gene normally helps white blood cells develop properly. When it rearranges or fuses with a partner gene, it can trigger uncontrolled cell growth, leading to a type of blood cancer called B-cell acute lymphoblastic leukaemia (B-ALL).
This test is also referred to as the TCF3 rearrangement test or E2A-PBX1 fusion test. It uses bone marrow and peripheral blood samples and is performed using the FISH (fluorescence in situ hybridisation) method.
What Does an E2A (TCF3) Gene Rearrangement Test Measure?
The E2A (TCF3) gene rearrangement test looks for specific chromosomal fusions involving the TCF3 gene. The table below outlines the key targets:
| Target | What It Indicates |
|---|---|
| TCF3 gene rearrangement (overall) | Presence of any abnormal TCF3 chromosomal change |
| TCF3::PBX1 fusion | Most common TCF3 translocation in paediatric B-ALL; accounts for the majority of TCF3-positive cases |
| TCF3::HLF fusion | Rare but aggressive fusion associated with poor treatment response |
| TCF3::ZNF384 fusion | Less common fusion partner; seen in a small subset of cases |
TCF3 rearrangements are found in approximately 5 to 11% of paediatric B-cell precursor ALL patients. Identifying the specific fusion partner helps doctors classify the leukaemia subtype and plan treatment.
Why Is an E2A (TCF3) Gene Rearrangement Test Done?
Doctors order this test when a patient shows signs that may suggest leukaemia or when initial blood tests point toward an abnormality in white blood cells.
Common Symptoms That May Require This Test
Several symptoms may prompt a doctor to request this test. These include:
- Persistent fatigue and unusual weakness
- Easy bruising or unexplained bleeding
- Frequent infections that take longer than usual to resolve
- Bone or joint pain without a clear cause
- Swollen lymph nodes in the neck, armpits, or groin
- Abdominal pain or swelling
- Unexplained fever lasting several days
Conditions This Test Can Help Detect
This test is used to identify and classify specific blood disorders. It can help detect:
- B-cell acute lymphoblastic leukaemia (B-ALL), particularly in children
- TCF3::PBX1-positive B-ALL, classified by the WHO as a distinct subtype of B-cell lymphoblastic leukaemia
- TCF3::HLF-positive B-ALL, a rare and highly aggressive subtype
- Other rare TCF3 fusion subtypes involving partner genes such as ZNF384
E2A (TCF3) Gene Rearrangement Test for Chronic Disease Monitoring
This test also has an important role during and after leukaemia treatment. Quantitative detection of fusion genes like E2A-PBX1 using real-time RT-PCR can assess minimal residual disease (MRD), which is the small number of leukaemia cells that may remain after treatment. This helps doctors evaluate whether therapy is working, detect early signs of relapse, and confirm whether a patient is in remission.
How to Prepare and What to Expect
This test involves two sample types: a bone marrow aspirate and a peripheral blood draw. Here is what you need to know before your appointment.
Do You Need to Fast?
No fasting is required before this test. You may eat and drink normally on the day of your appointment.
Practical Tips Before Your Test
A little preparation helps ensure the procedure goes smoothly. Keep these points in mind:
- Bring a detailed clinical history including your symptoms, previous test results, and family history, as this is required for the test
- Inform your doctor about all current medications, particularly blood thinners or anticoagulants
- Disclose any known allergies, especially to local anaesthetics
- Discuss the need for sedation or pain relief with your doctor beforehand, as this is assessed individually
- Arrange for a family member or friend to accompany you, especially if sedation is administered
- Wear comfortable, loose-fitting clothing for easy access to the collection site
Step-by-Step Procedure
The test requires two separate samples collected on the same visit.
Bone Marrow Sample Collection:
- You will be positioned on your side or front, and the hip bone area (iliac crest) is identified as the collection site.
- The skin is cleaned with an antiseptic solution, and a local anaesthetic is injected to numb the area.
- A special needle is guided into the bone marrow space.
- A syringe is used to gently draw out approximately 3 ml of marrow material.
- The sample is placed into a sodium heparin (green) tube and sent to the laboratory under refrigerated conditions.
Peripheral Blood Sample Collection:
- A small blood sample of 3 ml is drawn from a vein in your arm using a standard needle, collected into a lavender (EDTA) tube, and dispatched alongside the bone marrow sample.
Factors That Can Affect Accuracy
Certain factors may influence the reliability of your results. These include:
- Poor sample quality or low cell count in the marrow
- Sample collected after chemotherapy has already begun, which may reduce detectable cells
- Improper handling or storage during transport
- Very low levels of leukaemia cells, which may cause a result to appear negative
- Cryptic (hidden) rearrangements that may require additional testing such as NGS or RT-PCR for confirmation
Understanding Your E2A (TCF3) Gene Rearrangement Test Results
Results from this test are interpreted in the context of your overall clinical picture. The table below outlines the general reference ranges:
| Parameter | Normal Result | Abnormal Result |
|---|---|---|
| TCF3 gene rearrangement | Not detected | Detected (rearrangement present) |
| TCF3::PBX1 fusion | Not detected | Detected |
| TCF3::HLF fusion | Not detected | Detected |
| TCF3::ZNF384 fusion | Not detected | Detected |
A normal result means no TCF3 gene rearrangement was found. An abnormal result indicates the presence of a specific chromosomal fusion, which your doctor will discuss with you in detail.
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
Prior chemotherapy can reduce the number of detectable leukaemia cells, which may affect the sensitivity of the test. If tumour cell levels are very low, some rearrangements may not be detected by FISH alone, and additional testing methods may be recommended.
How to Maintain Healthy Levels
This is a diagnostic test for a serious blood condition, so the concept of maintaining "healthy levels" through lifestyle changes does not apply in the conventional sense. However, these general steps support overall wellbeing during diagnosis and treatment:
- Eat a balanced diet with adequate nutrition to support your immune system
- Get sufficient rest, as fatigue is common during illness and treatment
- Keep all follow-up appointments with your haematologist or oncologist for timely monitoring
Lupin Diagnostics E2A (TCF3) Gene Rearrangement Test Price
The E2A (TCF3) gene rearrangement test is priced starting at ₹5,000 at Lupin Diagnostics. This test requires a visit to a Lupin Diagnostics centre, as home collection is not available for this procedure.
| City | Approximate Price (₹) |
|---|---|
| Mumbai | 5000 |
| Pune | 5000 |
| Bangalore | 5000 |
| Chennai | 5000 |
Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Booking your TCF3 test is straightforward. Follow these steps:
- Select the E2A (TCF3) gene rearrangement 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 10 days.
Frequently Asked Questions
The E2A (TCF3) gene rearrangement test is used to detect abnormal chromosomal changes in the TCF3 gene. These changes are associated with a specific type of blood cancer called B-cell acute lymphoblastic leukaemia. The test helps confirm the diagnosis and identify the exact subtype, which guides treatment planning.
Both a bone marrow aspirate and a peripheral blood sample are collected because bone marrow provides higher sensitivity for detecting leukaemia cells, while peripheral blood offers a complementary view of circulating abnormal cells. Together, they improve diagnostic accuracy.
The TCF3 test report is typically available within 10 days. This timeframe accounts for the specialised FISH analysis performed on both samples at a NABL-accredited laboratory.
A local anaesthetic is used to numb the area before the needle is inserted, so most patients experience minimal discomfort during the procedure. Some people feel a brief pressure or aching sensation when the marrow is drawn. Your doctor can discuss sedation or pain relief options with you beforehand.
A positive TCF3::PBX1 result means that this specific chromosomal fusion was detected. While this subtype was historically considered high-risk, modern intensive treatment protocols have significantly improved outcomes for most patients. Your oncologist will discuss the implications in detail.
Yes. Quantitative detection of fusion genes such as E2A-PBX1 is used to track minimal residual disease during treatment. This helps doctors assess whether therapy is effectively reducing leukaemia cells and whether the patient is moving towards remission.
Yes. Clinical history is required for this test. Bring a detailed record of your symptoms, any previous test results, imaging reports, and a list of current medications. This information is essential for accurate interpretation of your results by the laboratory and your treating doctor.
E2A (TCF3) Gene Rearrangement Test: Booking, Price, and Results
