IS - BCR-ABL1 Quantitative (p210,p190,p230) Test
About IS - BCR-ABL1 Quantitative (p210,p190,p230) Test
| Field | Value |
|---|---|
| Also Known As | BCR-ABL Quantitative PCR, Philadelphia Chromosome Test, BCR-ABL1 IS Scale Test, BCR::ABL1 Quantitative RT-PCR |
| Sample Type | Peripheral blood (EDTA tube) or bone marrow aspirate |
| Fasting Required | No fasting required |
| Report Time | 5 days |
| Recommended For | Adults and children with suspected or confirmed CML or Ph+ ALL; all genders |
| Price | Starting at ₹6,800 |
What Is an IS - BCR-ABL1 Quantitative (p210,p190,p230) Test?
The IS - BCR-ABL1 Quantitative test detects and measures a specific genetic abnormality, called the BCR-ABL1 fusion gene, in the blood or bone marrow. This fusion gene produces an abnormal protein that drives certain types of blood cancer. Doctors order this test to diagnose and monitor conditions such as chronic myeloid leukaemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL). It is also known as the BCR-ABL Quantitative PCR or the Philadelphia Chromosome Test.
What Does an IS - BCR-ABL1 Quantitative (p210,p190,p230) Test Measure?
This test uses a method called Real-Time PCR to detect and quantify three specific BCR-ABL1 fusion gene transcripts. Results are reported on the International Scale (IS) as a percentage. Here is what each component represents:
| Transcript | Also Called | Primary Association |
|---|---|---|
| p210 | Major breakpoint (M-BCR) | Present in over 95% of CML cases |
| p190 | Minor breakpoint (m-BCR) | Found in approximately 50% of Ph+ ALL cases |
| p230 | Micro breakpoint (µ-BCR) | Associated with chronic neutrophilic leukaemia (very rare) |
| BCR-ABL1 IS % | International Scale ratio | Measures treatment response over time |
The IS percentage is calculated by comparing the amount of BCR-ABL1 fusion mRNA to a normal reference gene (ABL1). A lower percentage indicates a better treatment response.
Why Is an IS - BCR-ABL1 Quantitative (p210,p190,p230) Test Done?
This is a specialised oncology test. A doctor may order it when a patient shows signs of a blood cancer or when ongoing monitoring of a known diagnosis is needed.
Common Symptoms That May Require This Test
Patients with CML or Ph+ ALL often present with the following symptoms, which may prompt a doctor to request this test:
- Persistent fatigue that does not improve with rest
- Unexplained weight loss
- Anaemia (low red blood cell count causing weakness and pallor)
- Night sweats
- Splenomegaly (an enlarged spleen, often felt as fullness or discomfort in the left abdomen)
- Frequent infections or easy bruising
- Unexplained fever
Conditions This Test Can Help Detect
This test helps identify or monitor several serious blood conditions. These include:
- Chronic myeloid leukaemia (CML)
- Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL)
- Acute myeloid leukaemia (in rare cases where the BCR-ABL1 abnormality is present)
- Minimal residual disease (MRD), meaning small numbers of cancer cells that remain after treatment
- Resistance to tyrosine kinase inhibitor (TKI) therapy, a class of targeted cancer drugs
IS - BCR-ABL1 Quantitative (p210,p190,p230) Test for Chronic Disease Monitoring
This test plays a key role in the long-term management of CML. Clinical guidelines recommend testing every three months for the first three years of TKI therapy, and every three to six months thereafter. Regular monitoring helps doctors assess whether treatment is working, detect early signs of relapse, and decide whether therapy adjustments are needed.
How to Prepare and What to Expect
No special preparation is needed for this test, but there are a few practical steps that will help the process go smoothly.
Do You Need to Fast?
No fasting is required for the IS - BCR-ABL1 Quantitative test. You may eat and drink as normal before providing your sample. No dietary restrictions apply.
Practical Tips Before Your Test
A little preparation before your visit will help ensure accurate results and a smooth appointment. Keep the following in mind:
- Bring a detailed clinical history, including your symptoms, previous test results, and family history, as this is required for the test.
- Carry all previous BCR-ABL1 test reports, as comparison across time points is essential for meaningful interpretation.
- Inform the doctor or phlebotomist about all medications you are currently taking, particularly any tyrosine kinase inhibitors (TKIs).
- Ensure your sample reaches the laboratory promptly after collection, as RNA (the genetic material being tested) breaks down quickly.
Step-by-Step Procedure
This test requires either a peripheral blood sample or a bone marrow aspirate. Both options are described below.
Peripheral Blood Collection:
- A trained phlebotomist will clean the inner elbow area with an antiseptic swab.
- A tourniquet (elastic band) is applied to the upper arm to make veins easier to access.
- A small needle is used to draw approximately 3 mL of blood into a lavender-top EDTA tube.
- The needle is removed, and gentle pressure is applied to the site with a cotton swab.
- The sample is labelled, refrigerated immediately, and dispatched to the laboratory without delay.
Bone Marrow Collection:
- A doctor will administer local anaesthesia to the collection site (usually the hip bone).
- A special needle is inserted to withdraw approximately 3 mL of bone marrow aspirate.
- The sample is collected into a green-top sodium heparin tube.
- The site is dressed, and the patient is monitored briefly before discharge.
- The sample is refrigerated and transported to the laboratory as quickly as possible.
Factors That Can Affect Accuracy
Several factors can influence the reliability of your test result. These include:
- Delayed sample transport (specimens older than 48 to 72 hours may fail testing due to RNA degradation)
- Poor sample handling or storage at incorrect temperatures
- Low quantity or quality of RNA isolated from the sample
- Differences in laboratory methods or control genes used between facilities
- Only changes of 0.5 log or greater in BCR-ABL1 levels are considered clinically significant
Understanding Your IS - BCR-ABL1 Quantitative (p210,p190,p230) Test Results
Results are reported as a percentage on the International Scale (IS). Your doctor will interpret the value in the context of your diagnosis, treatment history, and previous results. The table below shows the standard molecular response milestones used in clinical practice.
| Response Level | Milestone Label | BCR-ABL1 IS % |
|---|---|---|
| Standardised Baseline | MR1 | 100% |
| Partial Cytogenetic Response | — | 10% or below |
| Complete Cytogenetic Response | — | 1% or below |
| Major Molecular Response (MMR) | MR3 | 0.1% or below |
| Deep Molecular Response | MR4 | 0.01% or below |
| Deep Molecular Response | MR4.5 | 0.0032% or below |
| Undetectable | MR5 | 0.001% or below |
Optimal treatment milestones, per international guidelines, are: 10% or below at 3 months, 1% or below at 6 months, and 0.1% or below (major molecular response) at 12 months.
"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 circumstances can affect how results are read:
- Patients with the p230 transcript and neutrophilic CML typically follow an indolent (slow-moving) course, likely because p230 mRNA and protein levels are naturally lower.
- A negative or undetectable result does not entirely rule out the presence of BCR-ABL1 transcripts below the detection limit of the assay, or rare transcript types not covered by the test.
- RNA degradation due to improper sample handling can produce a falsely low or undetectable result.
How to Maintain Healthy Levels
These general wellness tips support overall well-being during treatment and monitoring:
- Follow your prescribed TKI medication schedule closely, and do not miss doses without medical guidance.
- Attend all scheduled follow-up appointments so that molecular monitoring remains consistent and timely.
- Support your general health with balanced nutrition and adequate rest, which can help your body during treatment.
Lupin Diagnostics IS - BCR-ABL1 Quantitative (p210,p190,p230) Test Price
The IS - BCR-ABL1 Quantitative test cost at Lupin Diagnostics starts at ₹6,800. This test requires a visit to a Lupin Diagnostics centre; home collection is not available for this test due to the specialised sample handling and transport requirements involved.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 6800 |
| CHENNAI | 8160 |
| HYDERABAD | 6800 |
| KOLKATA | 8160 |
| NAVI MUMBAI | 6800 |
| PUNE | 6800 |
Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Booking your IS - BCR-ABL1 Quantitative test online with 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 5 days.
Frequently Asked Questions
The IS - BCR-ABL1 Quantitative test is used to detect the BCR-ABL1 fusion gene in patients with suspected or confirmed blood cancers such as CML and Ph+ ALL. Once a positive result is established, the test is used to track treatment response and detect minimal residual disease (very small amounts of cancer cells remaining after treatment).
Clinical guidelines recommend testing every three months for the first three years after starting TKI therapy. After that, testing every three to six months is generally advised. Your doctor will determine the exact schedule based on your response to treatment.
The International Scale is a standardised system used across laboratories to report BCR-ABL1 levels consistently. Results are expressed as a percentage, where a lower value indicates a better treatment response. A value of 0.1% or below is defined as a major molecular response (MMR).
These refer to three different sizes of the BCR-ABL1 fusion protein, each arising from a different genetic breakpoint. The p210 protein is found in over 95% of CML cases, p190 is associated with approximately 50% of Ph+ ALL cases, and p230 is a rare variant linked to chronic neutrophilic leukaemia.
This test uses either a peripheral blood sample (collected in a lavender-top EDTA tube) or a bone marrow aspirate (collected in a green-top sodium heparin tube). The test schedule runs Monday through Saturday, and the report is delivered within 5 days.
Yes. Because this test can identify very small amounts of BCR-ABL1 transcripts in the blood, it can pick up early signs of relapse even before symptoms appear. This is one of the key reasons regular BCR-ABL1 Quantitative test monitoring is recommended for all patients on long-term TKI therapy.
IS - BCR-ABL1 Quantitative (p210,p190,p230) Test
