Ph-like ALL is a unique subtype of B-cell ALL with a gene expression signature similar to that of ALL bearing the BCR-ABL1 fusion, but lacking that specific translocation. Patients with Ph-like ALL
have a very poor prognosis, but respond well to targeted therapy if the proper molecular feature can be identified. The WHO has stated, "From a practical standpoint, it is difficult to identify these leukemias
without complex laboratory analysis, and it is also difficult to screen cases of B-ALL to determine whice cases would need such analysis." Thus, there is intense interest in the hematology/oncology community in laboratory
assays that can rapidly and accurately identify Ph-like ALL.
TriCore Reference Laboratories now offers a screening assay and diagnostic algorithm for the identification of BCR-ABL1-like B-lymphoblastic leukemia/lymphoma (B-ALL). This entity accounts for 10-20% of pediatric ALLs
and 20-30% of adult cases.
TriCore's simple and comprehensive approach begins with the low density array (LDA) card screening. This screening assay identifies the Ph-like gene expression signature, regardless of the specific genes involved.
We then reflex as necessary to additional assays including FISH rearrangements in high-incidence genes, a RNA gene
fusion panel, and a multiplex next generation sequencing panel evaluating a large number of genes known to be associated with BCR-ABL1-like B-ALL.
TriCore's algorithm is the first commercially and clinically available option to screen for BCR-ABL1-like B-ALL and will become an integral part of your workup for B-ALL.
