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SALSA® MLPA® Probemix P335 ALL-IKZF1 detects copy number variations in the IKZF1, EBF1, CDKN2A/B, PAX5, ETV6, BTG1 and RB1 genes and in the PAR1 region.
Contents: 57 MLPA probes, including 8 probes for IKZF1 covering all 8 exons, 7 probes for PAX5, 6 for ETV6, 5 for RB1, 4 for BTG1 and downstream region, 4 for EBF1, 3 for the CDKN2A/CDKN2B region, and 5 for the Xp22.33/Yp11.32 region including PAR1.
Tissue: genomic DNA isolated from human peripheral whole blood or bone marrow.
Application: acute lymphoblastic leukemia (ALL).
CE-marked and registered for in vitro diagnostic (IVD) use in selected territories.
The SALSA MLPA Probemix P335 ALL-IKZF1 is an in vitro diagnostic (IVD) or a research use only (RUO) semi-quantitative assay for the detection of deletions of the IKZF1 gene for stratification of patients with acute lymphoblastic leukemia (ALL) into prognostic subgroups. The SALSA MLPA Probemix P335 ALL-IKZF1 is a RUO assay2 for the detection of deletions or duplications in B-cell differentiation and cell cycle control genes (EBF1, CDKN2A/B, PAX5, ETV6, BTG1 and RB1) and in the PAR1 region. This assay is for use on genomic DNA isolated from human peripheral whole blood and bone marrow specimens.
Note that the clinical relevance of some genes in the P335 ALL-IKZF1 probemix is not yet fully established. Therefore, the CE mark for diagnostic use only applies to the IKZF1 gene, and all other genes in the probemix are meant to be used in a research setting only.
For the full intended purpose, see the product description.
The overall incidence rate of ALL amounts to 1.6 in 100,000 per year (Malard and Mohty 2020). The peak incidence lies in childhood at an age of less than 5 years; thereafter, the incidence rate declines continually until the age of 50 years. After that, incidence slightly rises a second time. In patients over 50 years it rises a second time and reaches another peak at the age of over 80 years). There is a slight predominance of males (1.2:1). B-cell ALL accounts for 75% of all cases of ALL and T-cell ALL accounts for the remaining 25% of cases (https://www.lls.org/leukemia/acute-lymphoblastic-leukemia/diagnosis/all-subtypes).
Partial or complete deletions of the IKZF1 (IKAROS family zinc finger 1) gene are frequently detected in ALL cases (Mullighan et al. 2008), especially in those patients who also carry the BCR-ABL1 gene fusion (Philadelphia chromosome). IKZF1 deletions can be identified in approximately 70% of the children with Philadelphia chromosome-positive (Ph+) ALL (2-4% of all paediatric ALL cases), in 10-15% of Philadelphia chromosome-negative (Ph−) paediatric ALL, and in 40% of adult B-cell precursor ALL cases (Bernt and Hunger 2014; Lejman et al. 2022; van der Sligte et al. 2015). Deletion of IKZF1 is associated with a poor prognosis in B-ALL patients (Mullighan et al. 2009a) and a higher chance of relapse (Kuiper et al. 2010).
Several other (partial) gene deletions and duplications, such as in PAX5, ETV6, RB1, BTG1, EBF1 and CDKN2A/2B, have also been described in ALL patients. Prognostic profiles combining these aberrations, such as the IKZF1plus profile (IKZF1 deletions that co-occur with deletions in CDKN2A, CDKN2B, PAX or PAR1 in the absence of ERG deletion; Stanulla et al. 2018), have been described in recent years. See Table 2 for more information on all genes and regions covered in this probemix.
SALSA MLPA Probemix P335 ALL-IKZF1 is CE-marked for in vitro diagnostic (IVD) use. This assay has also been registered for IVD use in Colombia, Costa Rica and Israel.
This assay is for research use only (RUO) in all other territories.
A general SALSA MLPA Reagent Kit is required for MLPA experiments (to be ordered separately).
Inclusion of a positive sample is usually not required, but can be useful for the analysis of your experiments. MRC Holland has very limited access to positive samples and cannot supply such samples. We recommend using positive samples from your own collection. Alternatively, you can use positive samples from an online biorepository, such as the Coriell Institute.
See this support article for commercially available positive samples that have been tested with this product.