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Updated: Oct 9, 2025
Methods to Discover Alternative Promoter Usage and Transcriptional Regulation of Murine Bcrp1
Published on: May 27, 2016
BCR-ABL1 (p210) Transcript Kinetics
David P Ng1, Kristin Hunt Karner1
1From the Department of Pathology, University of Utah, Salt Lake City, Utah, and Section of Hematopathology, ARUP Laboratories, Salt Lake City, Utah.
Context.—:
Delta checks are a powerful technique for monitoring clinical assays in many disciplines but have not been routinely used in molecular testing.
Objective.—:
To determine if the biologically determined kinetics of BCR-ABL1's rise and fall could allow the development of a delta check in BCR-ABL1 testing.
Design.—:
Nine years of BCR-ABL1 p210 results were evaluated, and patients with 3 or more results were selected for inclusion. The kinetics of these percentages of international standard values were plotted against time along with the median and the 90th and 95th percentile lines. A Monte Carlo simulation of a batch mix-up was performed for 6 months of data to determine the efficacy of the proposed cutoff.
Results.—:
The median kinetics showed a 1-log drop of the percentage of international standard in 90 days, with less than 5% of cases showing faster than a 2-log drop in 90 days, and less than 2.5% showing a faster than 3-log drop in 90 days (extrapolated to 1 log in 30 days). The Monte Carlo simulation of a batch mix-up showed that an average batch mix-up of 23 samples could routinely be flagged by this cutoff, albeit with wide variance.
Conclusions.—:
These results suggest that using a drop in the percentage of international standard of greater than 1 log in 30 days can be a useful trigger in implementing a delta-check system for this molecular test.
