Ph-like ALL Panel [PDGFR α, PDGFR ß, E2A, MLL, CRLF2, TEL/AML, BCR/ABL] Test
About Ph-like ALL Panel [PDGFR α, PDGFR ß, E2A, MLL, CRLF2, TEL/AML, BCR/ABL] Test
| Field | Value |
|---|---|
| Also Known As | Ph-like ALL FISH panel, Philadelphia-like ALL panel, BCR-ABL1-like ALL panel, B-ALL FISH panel |
| Sample Type | Bone marrow aspirate (preferred) or peripheral blood |
| Fasting Required | No fasting is required (children undergoing sedation should follow separate pre-procedure guidelines). |
| Report Time | 8 days |
| Recommended For | Adults and children suspected of having acute lymphoblastic leukaemia (ALL) |
| Price | Starting at ₹20,400 |
What Is a Ph-like ALL Panel Test?
The Ph-like ALL panel test is a specialist genetic test used in haematology and oncology. It detects specific chromosomal abnormalities linked to Philadelphia chromosome-like acute lymphoblastic leukaemia (Ph-like ALL), a high-risk subtype of B-cell blood cancer. The test is also known as the Ph-like ALL FISH panel, BCR-ABL1-like ALL panel, or B-ALL FISH panel.
A haematologist or oncologist typically orders this test when a patient shows signs of ALL and further genetic characterisation is needed. The preferred specimen is a bone marrow aspirate, although a peripheral blood sample may also be collected where appropriate.
What Does a Ph-like ALL Panel Test Measure?
This panel uses Fluorescence In Situ Hybridisation (FISH), a technique that uses special fluorescent probes to detect specific genetic changes in cells. It analyses the following gene targets:
| Gene Target | What It Detects |
|---|---|
| PDGFRα (platelet-derived growth factor receptor alpha) | Rearrangements that can drive abnormal cell growth signals. |
| PDGFRβ (platelet-derived growth factor receptor beta) | Rearrangements involving the PDGFRβ gene that may be associated with abnormal cell signalling and potential sensitivity to targeted therapies. |
| E2A (TCF3) | Rearrangements on chromosome 19 are associated with variable prognosis. |
| MLL (KMT2A) | Rearrangements on chromosome 11 are linked to poor prognosis in ALL. |
| CRLF2 | Gene rearrangement is found in about 67% of Ph-like ALL cases; it activates a key growth pathway. |
| TEL/AML1 (ETV6/RUNX1) | Fusion of genes on chromosomes 12 and 21; common in paediatric ALL, generally favourable prognosis. |
| BCR/ABL1 | Detects the classic Philadelphia chromosome translocation, distinguishing Ph-positive ALL from Ph-like ALL. |
Why Is a Ph-like ALL Panel Test Done?
Doctors order this panel to characterise the genetic profile of leukaemia in patients already suspected of having ALL. It guides diagnosis, prognosis, and treatment planning.
Common Symptoms That May Require This Test
A doctor may request the Ph-like ALL panel test when a patient presents with the following symptoms:
- Persistent fatigue and unexplained weakness
- Easy or spontaneous bruising and bleeding
- Frequent infections that do not resolve quickly
- Pallor (paleness of skin) related to anaemia
- Fever, night sweats, and unintentional weight loss
- Swollen lymph nodes, or an enlarged liver or spleen
Conditions This Test Can Help Detect
This panel helps identify or confirm the following conditions:
- Philadelphia-like acute lymphoblastic leukaemia (Ph-like ALL)
- Philadelphia chromosome-positive ALL (BCR/ABL1 positive)
- Chromosomal abnormalities associated with specific ALL subtypes, including MLL rearrangements and TEL/AML1 fusions
- Kinase-activating genetic alterations that may be treatable with targeted therapy
Ph-like ALL Panel Test for Chronic Disease Monitoring
This test is also used to monitor patients already diagnosed with ALL. It helps track treatment response and may be repeated at intervals to assess whether residual disease is present. When earlier cytogenetic testing has been inconclusive or unsuccessful, this panel can provide additional prognostic information. Results help the oncology team decide whether to adjust therapy.
How to Prepare and What to Expect
Preparation for this test is straightforward, but the bone marrow collection procedure requires a few specific steps to ensure safety and sample quality.
Do You Need to Fast?
No fasting is required for this test. However, if the patient (particularly a child) will receive sedation or general anaesthesia during the bone marrow aspiration, the treating doctor will provide separate guidelines on eating and drinking before the procedure. Follow those instructions carefully.
Practical Tips Before Your Test
- Bring a detailed clinical history including your symptoms, previous test results, and relevant haematology reports, as clinical history is required for this test.
- Inform your doctor about all medications you are currently taking, as some may affect the sample or results.
- Wear loose, comfortable clothing that allows easy access to the hip area.
- Discuss sedation options with your doctor beforehand, especially if the patient is a child.
Step-by-Step Procedure
The preferred specimen is a bone marrow aspirate, although a peripheral blood sample may also be collected where appropriate. Here is what to expect at the appointment:
Bone Marrow Sample Collection:
- A healthcare professional examines the lower back or hip area to identify the correct collection site, then cleans the skin with an antiseptic solution.
- A local anaesthetic is injected to numb the area. The adequacy of anaesthesia is checked before proceeding.
- A thin, hollow needle attached to a syringe is inserted into the hipbone (iliac crest) to withdraw a small bone marrow sample.
- Approximately 3 mL of bone marrow is transferred into a sodium heparin (green-top) tube.
Peripheral Blood Sample Collection:
- A separate blood sample of approximately 3 mL is drawn from a vein, typically in the arm, and collected into an EDTA (lavender-top) tube.
- Both samples are labelled and transported to the laboratory under refrigerated conditions (2 to 8°C) for FISH analysis.
Factors That Can Affect Accuracy
- Clotted or paraffin-embedded specimens are not acceptable and cannot be analysed.
- Inadequate sample volume or poor cell count reduces the quality of analysis.
- Delays in transporting the sample to the laboratory (beyond 48 hours) can compromise results.
- Prior chemotherapy may affect blast cell counts and overall sample quality.
- Genetic changes below the detection threshold of FISH are not identified by this panel.
Understanding Your Ph-like ALL Panel Test Results
Results from this panel should always be interpreted by a qualified haematologist or oncologist alongside your symptoms, medical history, and other test results.
| Parameter | Result | What It May Mean |
|---|---|---|
| PDGFRα | Rearrangement detected or not detected | Changes involving the PDGFRα gene may help identify a specific subtype of ALL and provide information relevant to treatment planning. |
| PDGFRβ | Rearrangement detected or not detected | Abnormalities in the PDGFRβ gene can contribute to leukaemia development and may help guide treatment decisions. |
| E2A (TCF3) | Rearrangement detected or not detected | Genetic changes involving E2A (TCF3) can assist in classifying the type of ALL and understanding disease characteristics. |
| MLL (KMT2A) | Rearrangement detected or not detected | Alterations in the KMT2A (MLL) gene are associated with certain ALL subtypes and may influence prognosis and treatment strategy. |
| CRLF2 | Rearrangement detected or not detected | Abnormal CRLF2 findings may indicate activation of pathways involved in cancer cell growth and support further molecular evaluation. |
| TEL/AML1 (ETV6/RUNX1) | Fusion detected or not detected | The presence of this fusion is a common genetic finding in childhood ALL and is often linked to a favourable treatment response. |
| BCR/ABL1 | Translocation detected or not detected | This translocation is characteristic of Philadelphia chromosome-positive ALL and may indicate eligibility for targeted therapies. |
Disclaimer: These interpretations 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
- Ph-like ALL occurs in approximately 10–15% of children and up to 20% of adults with ALL, with the highest prevalence reported among adolescents and young adults (approximately 25–30%).
- In patients where Ph-like mutations are identified, treatment may need to be escalated and targeted therapy considered.
- Prior chemotherapy can alter blast cell numbers, which may affect how clearly abnormalities appear in the sample.
How to Maintain Healthy Levels
This panel is a diagnostic tool for leukaemia, so the concept of maintaining "healthy levels" does not apply in the usual sense. General guidance includes:
- Follow your haematologist's or oncologist's treatment plan closely after receiving results.
- Attend all scheduled follow-up appointments for repeat testing as advised.
- Report any new or worsening symptoms to your doctor promptly so that the treatment plan can be reviewed.
Lupin Diagnostics Ph-like ALL Panel Test Price
The Ph-like ALL panel test cost starts at ₹20,400 at Lupin Diagnostics. This test requires a visit to a Lupin Diagnostics centre. Home collection is not available for this test due to the specialised nature of sample collection.
| City | Approximate Price (₹) |
|---|---|
| Mumbai | 20400 |
| Pune | 20400 |
| Bangalore | 20400 |
| Chennai | 20400 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Booking the Ph-like ALL panel test online is simple:
- 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 the stipulated turnaround time.
Frequently Asked Questions
The Ph-like ALL panel test detects specific chromosomal abnormalities linked to Philadelphia chromosome-like acute lymphoblastic leukaemia. It helps doctors confirm the leukaemia subtype, assess prognosis, and identify genetic changes that may respond to targeted treatment.
The primary sample is a bone marrow aspirate, taken from the hipbone using a thin, hollow needle under local anaesthesia. A peripheral blood sample is also collected from a vein in the arm. Both samples are needed for complete analysis.
You may feel a stinging sensation when the local anaesthetic is injected. As the bone marrow sample is collected, some patients experience a brief shooting pain in the hip and leg. The discomfort usually passes quickly. Sedation is available and is commonly offered to children.
The report for this Ph-like ALL panel test is typically delivered within 8 days. The timeline reflects the complexity of the FISH analysis involved.
A positive result means one or more chromosomal abnormalities were detected in the sample. This helps classify the leukaemia subtype, guides prognosis, and informs the treating team about whether targeted therapies such as tyrosine kinase inhibitors may be appropriate.
Ph-like ALL is associated with a poor prognosis in both children and adults. However, identifying the specific genetic alterations present means that certain targeted therapies may be effective. Early and accurate identification allows for a more personalised treatment approach.
No. The Ph-like ALL panel test home collection option is not available. Bone marrow aspiration must be performed by trained medical professionals in a hospital or diagnostic centre setting.
Ph-like ALL Panel [PDGFR α, PDGFR ß, E2A, MLL, CRLF2, TEL/AML, BCR/ABL] Test
