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SALSA MLPA Probemix P335 ALL-IKZF1

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.

Specifications

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.

Intended purpose

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.

Clinical background

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.

Regulatory status

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.

List prices

Product

Item no.
Description
Technology
Price
P335-025R
SALSA MLPA Probemix P335 ALL-IKZF1 – 25 rxn
€ 281.00
P335-050R
SALSA MLPA Probemix P335 ALL-IKZF1 – 50 rxn
€ 550.00
P335-100R
SALSA MLPA Probemix P335 ALL-IKZF1 – 100 rxn
€ 1075.00

Required reagents

A general SALSA MLPA Reagent Kit is required for MLPA experiments (to be ordered separately).

Item no.
Description
Technology
Price
EK1-FAM
SALSA MLPA Reagent Kit – 100 rxn – FAM (6 vials)
€ 341.00
EK1-Cy5
SALSA MLPA Reagent Kit – 100 rxn – Cy5 (6 vials)
€ 341.00
EK5-FAM
SALSA MLPA Reagent Kit – 500 rxn – FAM (5×6 vials)
€ 1571.00
EK5-Cy5
SALSA MLPA Reagent Kit – 500 rxn – Cy5 (5×6 vials)
€ 1571.00
EK20-FAM
SALSA MLPA Reagent Kit – 2000 rxn – FAM (5×6 vials)
€ 6037.00

Price details & ordering

The prices above are list prices for direct orders from MRC Holland. Contact us for a quote that takes discounts and additional costs (such as shipping costs) into account. Different prices apply for orders through one of our sales partners; contact your local supplier for a quote.

Positive samples

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.

The commercially available positive samples below have been tested with the current (C2) version of this product and have been shown to produce useful results.

  • Coriell NA01353 (m): Heterozygous deletion affecting the probes for SHOX, CRLF2 and CSF2RA on chromosome Xp (PAR1 region).
  • Coriell NA01750 (m): Heterozygous duplication affecting the probes for JAK2, CDKN2A and CDKN2B on chromosome 9p.
  • Coriell NA04371 (m): Heterozygous duplication affecting the probes for EBF1 on chromosome 5q and CSF2RA on chromosome Xp (PAR1 region).
  • Coriell NA05067 (m): Heterozygous duplication affecting the probes for JAK2, CDKN2A, CDKN2B and PAX5 on chromosome 9p.
  • Coriell NA07081 (m): Heterozygous duplication affecting the probes for IKZF1 on chromosome 7p.
  • Coriell NA07981 (m): Heterozygous triplication / homozygous duplication affecting the probes for ETV6 on chromosome 12p.
  • Coriell NA09403 (f): Heterozygous deletion affecting the probes for SHOX, CRLF2, CSF2RA, IL3RA and P2RY8 on chromosome Xp (PAR1 region).
  • Coriell NA10925 (m): Heterozygous deletion affecting the probes for IKZF1 on chromosome 7p. Heterozygous duplication affecting the probes for CRLF2 and CSF2RA on chromosome Xp (PAR1 region).
  • Coriell NA12606 (m): Heterozygous duplication affecting the probes for RB1 on chromosome 13q.
  • Coriell NA12722 (m): Heterozygous duplication affecting the probes for JAK2, CDKN2A and CDKN2B on chromsome 9p. Some of the reference probes are affected by CNAs.
  • Coriell NA14164 (f): Heterozygous deletion affecting the probes for RB1 on chromosome 13q.
  • DSMZ ACC-20 (BV-173) (f): Heterozygous deletion affecting the probes for IKZF1 (exons 1-7) on chromosome 7p, CDKN2A (exon 4) on chromosome 9p and probes targeting the PAR1 region on chromosome Xp. Homozygous deletion affecting the probes for CDKN2A (exon 2) and CDKN2B (exon 2) on chromosome 9p. Some of the reference probes are affected by CNAs.

Publications

References

  • Bernt KM et al. (2014). Current concepts in pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia. Front Oncol. 4:54.
  • Kuiper RP et al. (2010). IKZF1 deletions predict relapse in uniformly treated pediatric precursor B-ALL. Leukemia. 24:1258-64.
  • Lejman M et al. (2022). Genetic Biomarkers and Their Clinical Implications in B-Cell Acute Lymphoblastic Leukemia in Children. Int J Mol Sci. 23:2755.
  • Malard F et al. (2020). Acute lymphoblastic leukaemia. Lancet. 395:1146-62.
  • Mullighan CG et al. (2008). BCR-ABL1 lymphoblastic leukaemia is characterized by the deletion of Ikaros. Nature. 453:110-4.
  • Mullighan CG et al. (2009a). Deletion of IKZF1 and prognosis in acute lymphoblastic leukemia. N Engl J Med. 360:470-80.
  • Stanulla M et al. (2018). IKZF1plus Defines a New Minimal Residual Disease-Dependent Very-Poor Prognostic Profile in Pediatric B-Cell Precursor Acute Lymphoblastic Leukemia. J Clin Oncol. 36:1240-9.
  • Van der Sligte NE et al. (2015). Effect of IKZF1 deletions on signal transduction pathways in Philadelphia chromosome negative pediatric B-cell precursor acute lymphoblastic leukemia (BCP-ALL). Exp Hematol Oncol. 4:23.

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CE

CE-marked products are for In Vitro Diagnostic (IVD) use only in EU (candidate) member states and members of the European Free Trade Association (EFTA), and the UK.

CO

IVD-registered in Colombia.

CR

IVD-registered in Costa Rica.

IL

IVD-registered in Israel.