BCR-ABL1 Kinase Domain Mutation Analysis by NGS

What is BCR-ABL1?

BCR-ABL1 is an abnormal fusion gene formed by joining the BCR and ABL1 genes due to a translocation between chromosomes 9 and 22, known as the Philadelphia chromosome. It produces an overactive tyrosine kinase enzyme that drives the development of chronic myeloid leukemia (CML) and Ph+ acute lymphoblastic leukemia (Ph+ ALL). Detecting and monitoring BCR-ABL1 mutations is essential for diagnosis, tracking treatment response, and identifying resistance to tyrosine kinase inhibitors (TKIs), allowing timely and personalised treatment decisions.

Why NGS Is the Preferred Method for BCR-ABL1 Mutation Testing

Assay Characteristics NGS Sanger Sequencing | RT-PCR
Throughput High Low | Medium
Sensitivity of Mutation Detection
(Limit of Detection)
>1% >20% | >5%
Detection of Novel Mutations Yes Limited | No
Differentiation of Compound
Mutations
Yes No
Identification of Polyclonal Mutations Yes No
Quantification of Mutation Burden Yes No

Clinical Applications of BCR-ABL1 Test

  • Supports diagnosis of chronic myeloid leukemia and Philadelphia-positive acute lymphoblastic leukemia.
  • Guides early intervention, dose adjustment, and treatment changes in case of rising BCR-ABL1 transcript levels.
  • Identifies over 130 known and novel kinase domain mutations with high sensitivity.
  • Determines whether resistance is due to polyclonal or compound mutations.
  • Supports clinical decisions in cases of accelerated phase or blast crisis.
  • Enables longitudinal tracking of mutation dynamics over time.

Specifications

  • Indications: Imatinib or TKI treated chronic myeloid leukemia or Philadelphia chromosome-positive or Acute Lymphoblastic Leukemia patients developing resistance.
  • Methodology: Next-Generation Sequencing
  • Sample Type: 3-4 mL of peripheral blood in EDTA tube / 1μg of RNA.
  • Accuracy: Limit of detection is ≥1% VAF with 100% sensitivity and specificity.
  • Coverage: Detects all known / unknown / rare mutations and not just the hotspots.
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BCR-ABL1 Test Offered by MedGenome

Key Highlights of MedGenome's BCR-ABL1 Test

Higher Sensitivity

Detects low-level mutations with ≥1% variant allele frequency (VAF).

Better Coverage

Identifies known, rare, novel, and compound mutations across the BCR-ABL1 gene.

Enhanced Accuracy

Offers superior precision compared to Sanger and PCR-based methods.

What is BCR-ABL1?

The BCR-ABL1 gene is a result of an abnormal fusion between segments of the BCR and ABL1 genes. This fusion gene is frequently observed in individuals diagnosed with chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). The aberrant protein produced by the BCR-ABL1 gene drives the uncontrolled proliferation of white blood cells. Consequently, identifying this gene plays a crucial role in both the diagnosis and management of these specific blood cancers.

How is the BCR-ABL1 Test Done?

Step What Happens
1. Sample Collection A small blood sample is taken, usually from a vein in your arm.
2. RNA Extraction The lab isolates genetic material (RNA) from your blood cells.
3. Genetic Testing Using NGS, the BCR-ABL1 gene is analysed for known and new mutations.
4. Report Generation The results are interpreted by genetic experts and shared with your doctor.
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Why Is a BCR-ABL1 Test Done?

A BCR-ABL1 test helps diagnose certain types of leukemia and monitor how well treatment is working. It can detect the gene responsible for abnormal cell growth and help your doctor:

  • Confirm a diagnosis of CML or Ph+ ALL.
  • Check if the patients body is responding to tyrosine kinase inhibitors (TKIs) like imatinib.
  • Identify any mutations that may cause resistance to drugs / therapies, namely TKI (Tyrosine kinase inhibitors).
  • Decide if a change in medication or treatment plan is needed.

How Does the BCR-ABL1 Test Work?

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Who Should Consider the BCR-ABL1 Test?

Your doctor may recommend a BCR-ABL1 test if:

  • You’ve been diagnosed with CML or Ph+ ALL.
  • Your leukemia is not responding well to the current treatment.
  • Your blood test shows an increase in BCR-ABL1 levels after treatment.
  • You’re entering an advanced phase of the disease.
  • Your doctor suspects that your body may have developed resistance to TKIs.

What Do the BCR-ABL1 Test Results Mean?

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When is the Best Time to Get a BCR-ABL1 Test?

You should get a BCR-ABL1 test:

  • At diagnosis, to confirm the presence of the BCR-ABL1 gene.
  • During treatment, especially if your BCR-ABL1 levels are rising.
  • If treatment is not working as expected.
  • Before switching to a new TKI therapy, check for resistance mutations.

Can the BCR-ABL1 Test Detect All Causes of Endometrial Cancer?

Why Choose MedGenome for BCR-ABL1 Testing?

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