iAMP (21) Test: Booking, Price, and Results
About iAMP (21) Test
| Field | Value |
|---|---|
| Also Known As | iAMP21 FISH Test, Intrachromosomal Amplification of Chromosome 21 Test, RUNX1 Amplification Test |
| Sample Type | Bone marrow, peripheral blood |
| Fasting Required | Not required |
| Report Time | 8 days |
| Recommended For | All ages; primarily used in children and adolescents with suspected or confirmed B-cell precursor acute lymphoblastic leukaemia |
| Price | Starting at ₹4,800 |
What Is an iAMP (21) Test?
The iAMP (21) test detects a specific chromosomal abnormality in leukaemia cells known as intrachromosomal amplification of chromosome 21. It uses a laboratory method called fluorescence in situ hybridisation, or FISH, to count copies of the RUNX1 gene on chromosome 21. The test is most commonly ordered for children and adolescents diagnosed with B-cell precursor acute lymphoblastic leukaemia (BCP-ALL). It may also be referred to as the iAMP21 FISH test, the intrachromosomal amplification of chromosome 21 test, or the RUNX1 amplification test.
What Does an iAMP (21) Test Measure?
The iAMP test evaluates a single genetic parameter. The table below explains what is assessed:
| Parameter | What It Measures |
|---|---|
| RUNX1 gene copy number | The number of copies of the RUNX1 gene present per cell, detected using FISH probes specific to chromosome 21 |
A normal cell carries two copies of the RUNX1 gene, one on each chromosome 21. In iAMP21, five or more RUNX1 signals are found per cell, with at least three extra copies located on a single abnormal chromosome 21. This pattern defines the iAMP21 subgroup of BCP-ALL and has direct implications for treatment planning.
Why Is an iAMP (21) Test Done?
The iAMP (21) test is a specialised cytogenetic test ordered when a patient is diagnosed with or suspected to have B-cell acute lymphoblastic leukaemia, and the treating doctor needs to identify the specific chromosomal subtype to guide treatment intensity.
Common Symptoms That May Require This Test
The following symptoms may prompt a doctor to investigate for leukaemia and order further cytogenetic testing, including the iAMP test:
- Unusual tiredness or persistent fatigue
- Easy bruising or unexplained bleeding
- Enlarged lymph nodes (swollen glands in the neck, armpits, or groin)
- Bone and joint pain without a clear cause
- Abdominal pain or swelling
- Frequent or recurrent infections
Conditions This Test Can Help Detect
This test is used to identify or rule out the following:
- Intrachromosomal amplification of chromosome 21 (iAMP21), a distinct high-risk subgroup of BCP-ALL
- High-risk cytogenetic status in childhood acute lymphoblastic leukaemia
- Eligibility for intensive, high-risk treatment protocols in B-ALL
iAMP (21) Test for Chronic Disease Monitoring
Once iAMP21 is confirmed, the test has ongoing value in monitoring the patient's response to treatment. It can assist in detecting minimal residual disease and assessing relapse risk. Because patients with iAMP21 have a higher rate of relapse when treated at standard intensity, identifying this abnormality early helps the medical team decide on treatment intensity, including whether early bone marrow transplantation may be appropriate.
How to Prepare and What to Expect
The iAMP test procedure requires bone marrow collection, which takes place in a hospital or clinical setting. Knowing what to expect in advance can help you feel more prepared.
Do You Need to Fast?
Fasting is not required for the test itself. However, if the bone marrow collection involves sedation or general anaesthesia, particularly in younger children, your doctor will give specific fasting instructions beforehand. Always follow the guidance provided by your treating physician.
Practical Tips Before Your Test
The following steps will help ensure a smooth experience:
- Bring a detailed clinical history, including symptoms, previous test results, and family history, as this is required for the test
- Inform the doctor about all current medications, supplements, or herbal remedies
- Mention any known allergies or bleeding disorders before the procedure
- Wear loose, comfortable clothing that allows easy access to the hip area
- Arrange for a responsible adult to accompany the patient home, especially if sedation will be used
Step-by-Step Procedure
Two sample types may be collected for this test: bone marrow and peripheral blood. The procedures for each are described below:
Bone Marrow Aspirate Collection:
- You will be asked to lie on your side or stomach. The sample is usually taken from the hip bone (posterior iliac crest).
- The skin over the area is cleaned with an antiseptic, and a local anaesthetic is injected to numb the site.
- A small cut is made in the skin, and a hollow needle is inserted into the bone.
- A syringe is attached, and bone marrow cells are drawn out (aspirated). You may feel brief pressure or a sharp sensation when the marrow is withdrawn.
- The needle is removed, and a dressing is applied. The entire procedure typically takes around 30 minutes.
- The bone marrow sample is collected in a sodium heparin (green-top) tube and sent to the laboratory under refrigerated conditions for FISH analysis.
Peripheral Blood Collection:
- A trained phlebotomist will clean the skin on the inside of your elbow.
- A needle is inserted into a vein, and approximately 3 ml of blood is drawn into an EDTA (lavender-top) tube.
- The needle is removed, and gentle pressure is applied to stop any bleeding.
- The blood sample is labelled and transported to the laboratory alongside the bone marrow specimen.
Factors That Can Affect Accuracy
- Insufficient blast cells in the sample (low tumour cell count)
- Improper handling or delayed transport of specimens beyond 24 to 48 hours
- Absence of metaphase cells, which limits confirmation of the FISH finding
- Hyperdiploid ALL, which can also show extra RUNX1 signals due to additional full copies of chromosome 21, not amplification
Understanding Your iAMP (21) Test Results
Results from the iAMP (21) test must always be reviewed alongside the patient's full clinical picture, including their diagnosis, other laboratory findings, and treatment history. The table below shows the reference values used in interpretation:
| Parameter | Result | Interpretation |
|---|---|---|
| RUNX1 signals per cell | 2 signals | Normal; no amplification detected |
| RUNX1 signals per cell | 5 or more signals, with 3 or more extra copies on a single abnormal chromosome 21 | Positive for iAMP21 |
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
In some atypical cases, fewer than five RUNX1 signals are observed, or extra signals are located away from the abnormal chromosome 21. These unusual findings may require chromosomal microarray testing for confirmation. Additionally, hyperdiploid BCP-ALL can produce extra RUNX1 signals that resemble iAMP21 on interphase FISH alone. Careful review of metaphase FISH and clinical context is important in such cases.
How to Maintain Healthy Levels
For patients undergoing monitoring after a confirmed iAMP21 diagnosis, the following general guidance applies:
- Attend all scheduled follow-up appointments with your haematology or oncology team so that any changes in your condition are detected early.
- Follow your prescribed treatment plan consistently, and do not stop or adjust medications without consulting your doctor.
- Report any new or returning symptoms such as unexplained fatigue, fever, or bruising to your doctor without delay.
Lupin Diagnostics iAMP (21) Test Price
The iAMP test cost at Lupin Diagnostics starts at ₹4,800. This test requires a bone marrow or peripheral blood sample and must be collected by a trained professional at a clinical facility. The iAMP (21) test home collection is not available.
| 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
Follow these steps for iAMP test online booking:
- Select the iAMP (21) test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time for peripheral blood sample collection. For bone marrow samples, please visit the hospital as directed by your doctor for sample collection.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Frequently Asked Questions
The iAMP (21) test is used to detect a specific chromosomal abnormality in leukaemia cells. It identifies intrachromosomal amplification of chromosome 21, which places a patient in a high-risk group for B-cell acute lymphoblastic leukaemia. The result directly influences which treatment protocol will be used.
This test is primarily ordered for children and adolescents diagnosed with B-cell precursor acute lymphoblastic leukaemia. iAMP21 occurs in approximately 2 to 5% of paediatric BCP-ALL cases. Doctors order it to determine risk category and guide treatment intensity.
Bone marrow is the preferred sample. It is collected from the hip bone using a needle under local anaesthesia. A peripheral blood sample may be used if circulating leukaemia cells are confirmed in the blood by a specialist. Both samples are collected in a clinical setting.
The area is numbed with a local anaesthetic before the needle is inserted, so pain is minimised. In younger children, sedation may be offered. Most patients tolerate the procedure well. Mild soreness at the collection site is common and typically resolves within a day or two.
Reports for the iAMP (21) test are typically available within 8 days of sample collection at Lupin Diagnostics. You will receive the report directly via email or WhatsApp.
Detecting iAMP21 directly influences treatment planning. Patients with this abnormality have a significantly higher risk of relapse when treated on standard-intensity protocols. Moving them to high-risk treatment arms has been shown to reduce relapse rates, making early and accurate detection essential.
A negative result means that no iAMP21 abnormality was detected in the sample. However, if leukaemia is still suspected, other cytogenetic abnormalities may need to be investigated. In borderline cases, chromosomal microarray testing may be recommended, as some iAMP21 cases may not be captured by FISH alone.
iAMP (21) Test: Booking, Price, and Results
