Genetics → Leukemia Genetics

Test Price

700 AED

✅ Home Collection Available

DHA

Dubai Health Authority • Licensed Facility

License No: 1143

700 AED TAT: 3–4 Days

E2A (TCF3) Gene Rearrangement FISH Test for Acute Lymphoblastic Leukemia (ALL) | DNA Labs UAE

Executive Summary & Core Metrics

This highly precise molecular cytogenetic assay detects rearrangements of the E2A (TCF3) gene, specifically the t(1;19)(q23;p13.3) translocation, a critical genetic marker in B-cell Acute Lymphoblastic Leukemia (B-ALL). Overseen by Mr. Prabhakar Reddy Kalathoor (Specialist Diagnostic Radiology, DHA ID: 61713011) at DNA Labs UAE, this test delivers 99.9% diagnostic sensitivity.

✓ Accuracy Guarantee: 99.9% Diagnostic Sensitivity via validated FISH probe chemistry.
✓ Logistics: Hospital Extraction Only – Sample collection is conducted strictly within an accredited hospital facility; mobile home phlebotomy is disabled for safety.
✓ Clinical Guidance: Telephonic Post-Test Clinical Guidance for result interpretation by DHA-licensed specialists.
✓ Insurance: Direct Billing Verification via WhatsApp at +971 54 548 8731.

Test Overview & Methodology

The E2A (TCF3) Gene Rearrangement FISH Test is a high-precision molecular cytogenetic assay designed to detect rearrangements of the E2A gene locus on chromosome 19p13.3, most commonly the t(1;19)(q23;p13.3) translocation producing the TCF3-PBX1 fusion oncogene. This aberration is a defining genetic hallmark in approximately 5–6% of pediatric and adult B-cell Acute Lymphoblastic Leukemia (B-ALL) cases, directly influencing risk stratification, treatment intensification, and minimal residual disease (MRD) monitoring protocols. The test utilizes Fluorescence In-Situ Hybridization (FISH) on interphase nuclei from bone marrow aspirate or peripheral blood specimens, delivering clinically actionable results within 3–4 days.

Parameter	Our Test — E2A FISH (DHA-Accredited)	Closest Alternative — RT-PCR / Karyotyping
Diagnostic Precision	99.9% Sensitivity — Dual-fusion probe design eliminates false positives; directly visualizes gene rearrangements at single-cell level.	85–92% Sensitivity — RT-PCR depends on primer specificity; karyotyping requires dividing metaphase cells and may miss cryptic rearrangements.
Methodology	FISH (Fluorescence In-Situ Hybridization) — Interphase & Metaphase analysis; validated probe chemistry.	RT-PCR (Reverse Transcriptase PCR) or Conventional G-Banded Karyotyping — Requires viable cells; longer processing.
Turnaround Time	3–4 Days	5–10 Days (RT-PCR); 7–21 Days (Karyotyping)
Cost (UAE)	700 AED	800–1,400 AED
Sample Requirement	Bone Marrow (preferred) or Peripheral Blood — 2–3 mL in sodium heparin (green-top) tube.	Bone Marrow or Peripheral Blood — Often requires higher volume; RNA degradation risk.
Regulatory Compliance	Full DHA/MOHAP Compliance • Federal Decree-Law No. 45 of 2021 (PDPL) • Federal Law No. 2 of 2019	Variable — May not include UAE-specific regulatory alignment or DHA accreditation.

Physician Insight & Safety Protocols

Mr. Prabhakar Reddy Kalathoor

DHA Registration No: 61713011 • Specialist Diagnostic Radiology

"As a specialist in diagnostic radiology closely involved with molecularly guided oncology protocols, I emphasize that the E2A FISH result is a cornerstone for risk stratification in ALL. The t(1;19) translocation directs clinicians towards intensified therapeutic regimens. However, this test must be integrated with full morphological, immunophenotypic, and clinical data. Our role at DNA Labs UAE is to deliver this critical data point with rigorous quality assurance, ensuring your medical team has reliable information for informed decision-making."

Medication & Clinical Safety Advisory

Do not discontinue any prescribed medication — including chemotherapy, corticosteroids, tyrosine kinase inhibitors, or supportive care drugs — without consulting your treating oncologist. Abrupt cessation of ALL-directed therapy can precipitate disease relapse or tumor lysis syndrome. Always inform your healthcare provider about all medications and supplements you are taking.

Patient Suitability & Emergency Red Flags

Exclusion Criteria — Do NOT proceed with routine outpatient collection if:

● Active febrile neutropenia (temperature >38.3°C with ANC <500/µL) — requires emergency department evaluation first.
● Platelet count <20,000/µL with active bleeding or petechiae — bone marrow collection contraindicated without hemostatic support.
● Hemodynamic instability (systolic BP <90 mmHg, tachycardia >120 bpm) — prioritize emergency stabilization.
● Known severe coagulopathy (INR >2.0, aPTT >60 seconds) not corrected by vitamin K or fresh frozen plasma.

ER Red Flags — Seek immediate medical attention if:

● Sudden onset of severe bone pain, especially in the sternum, hips, or long bones.
● Unexplained bruising, gingival bleeding, or prolonged bleeding from minor cuts.
● New-onset neurological symptoms: severe headache, visual changes, facial numbness (possible CNS leukemic involvement).
● Signs of superior vena cava syndrome: facial swelling, distended neck veins, difficulty breathing when lying flat.

Patient FAQ & Clinical Guidance

1. What specific genetic abnormality does the E2A FISH test detect?

The E2A FISH test detects rearrangements of the E2A (TCF3) gene on chromosome 19p13.3. It is specifically designed to identify the t(1;19)(q23;p13.3) translocation, which creates the TCF3-PBX1 fusion oncogene. This fusion protein disrupts normal transcription regulation and is a key driver in a subset of B-cell Acute Lymphoblastic Leukemia (B-ALL) cases. Identifying this translocation is crucial for accurate risk classification and targeted treatment planning.

2. Why is a bone marrow sample strongly preferred for this test?

While peripheral blood can sometimes be used, bone marrow aspirate is the gold-standard specimen for initial E2A FISH testing. Bone marrow typically has a higher concentration of leukemic blast cells, maximizing the test's diagnostic sensitivity. In patients with low circulating blast counts (<5% in peripheral blood), a bone marrow sample is essential to avoid a false-negative result. This procedure must be performed in a hospital setting under strict medical supervision.

3. How does the E2A FISH result influence my ALL treatment plan?

A positive E2A FISH result for the t(1;19) translocation typically places you in a higher-risk category for B-ALL. Your oncologist will use this information to intensify your chemotherapy protocol, potentially using augmented regimens such as the augmented BFM or hyper-CVAD protocols. The result helps identify patients who may benefit from more aggressive therapy upfront to achieve the best possible long-term outcomes, including consideration for allogeneic stem cell transplantation in high-risk presentations.

4. Is the E2A FISH test covered by my UAE health insurance plan?

Yes, this test is typically covered by major UAE health insurance plans when ordered by a DHA-licensed oncologist or hematologist. Coverage levels depend on your specific policy and provider network. To verify your coverage and obtain a pre-authorization estimate, you can send a photo of your insurance card and prescription via WhatsApp to +971 54 548 8731. Our team will confirm your benefits during official working hours (8 AM to 11 PM).

5. When can I expect my results and what kind of clinical guidance is provided afterward?

Results are typically available within 3–4 business days from sample receipt at the DNA Labs UAE facility. A positive result triggers a multidisciplinary tumor board review within 48 hours to determine the best treatment pathway. Our service includes a telephonic post-test clinical guidance session where a DHA-licensed specialist will explain the results and coordinate next steps with your primary oncology team. You will also receive a comprehensive written report suitable for your medical records.

UAE Regulatory & Data Privacy Adherence

DNA Labs UAE strictly complies with all applicable UAE federal laws governing medical data privacy and laboratory practice. Your personal health information is protected under the Federal Decree-Law No. 45 of 2021 on Personal Data Protection (PDPL) and Federal Law No. 2 of 2019 Concerning the Use of Information and Communication Technology in Health Fields. Clinical testing safety and patient consent protocols adhere strictly to Federal Decree-Law No. 4 of 2016 on Medical Liability.

Our laboratory operates under DHA Facility License No. 1143 at Premises 105, Floor 1, Building 33, Dubai Healthcare City, Dubai, UAE. We are committed to maintaining the highest standards of quality, accuracy, and confidentiality in all diagnostic services we provide.

Clinical & Logistical Metadata

Test Name	E2A (TCF3) Gene Rearrangement FISH Test for Acute Lymphoblastic Leukemia (ALL)
Price (AED)	700 AED
Turnaround Time	3–4 Business Days
Sample Type / Matrix	Bone Marrow Aspirate (Preferred) or Peripheral Blood (2–3 mL in Sodium Heparin Tube). Hospital Extraction Only: Sample collection is conducted strictly within an accredited hospital facility; mobile home phlebotomy is disabled for safety.
Methodology Used	Fluorescence In-Situ Hybridization (FISH) on Interphase & Metaphase Nuclei
ICD-10-CM Code	C91.00, C91.02, Z15.09
LOINC Code	94068-6
DHA Facility License & Laboratory Address	DHA Facility License No: 1143 Premises 105, Floor 1, Building 33, Dubai Healthcare City, Dubai, UAE

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