9 replies to this topic

[MJB]

I am trying to understand my test results from a bone marrow asperation. I've been having PCR tests on pb every three months and got comfortable with understanding the log reduction and how I was responding. I had a bma PCR test and I know you can't compare that to peripheral blood. 15 months ago after failing gleevec at the 12 month mark, my bone marrow was at 7.0 now it is 0.038, the nurse on the phone said the doctor was happy with this response. Is this current response good enough? What do I call it? MMR?

I get so confused!!! Trey? Lucky?

Thank you !!

IForget

[CallMeLucky]

The bone marrow and the peripheral aren't necessarily that far off it depends.  Mine were a little different and I think the marrow is susceptible to more swings.  Overall there should be a trend.  Do you have your last PB PCR results?  In general I would say a PCR of 0.038% is pretty low and would be a good place to be.

[CallMeLucky]

P.S. I'm trying to find out what MSKCC's lab considers MMR but have not had any luck.  When I ask the doctor, she just looks at my results and talks about the progress I have made as an individual.  I get the sense she isn't that interested in matching to averages and all that other nonsense.  She seems to be a little mistrusting of PCR at low level and just says as long as it is going down and staying nice and low, that is sufficient.

[MJB]

Yup, I agree with you Lucky. I couldn't get the nurse on the phone to answer that question either. The nurse said that they didn't have the FISH back yet and that they didn't do the PCR on the peripheral blood because they did it on the marrow. Thats what has thrown me off. If I am reading my log reductions on the marrow correctly, than I have a 2 log reduction at 15 months since failing gleevec. I wonder if this is good enough but the doc is happy so I should be happy, right? sigh..why do I worry?

[CallMeLucky]

When they did my BMB they also did not do a PB PCR so they are consistent in their protocol.  I was curious what your last PB PCR was from your last visit.

[Trey]

Your PCR from the 12 month point until now is approx a 2 1/2 log reduction during that time period; however, log reductions are not normally calculated from any point except diagnosis (or the lab standard for diagnosis).  But you have responded well since switching drugs.  That is all you really need to know.

[MJB]

My PB PCR was .033 in August. That was a 1 log increase from the prior test so I had it redone on a Friday, before the hurricane no less and it came back at .0001. That was great! But, because it was drawn on a Friday, I've been hesitant to celebrate and was counting on this PCR to verify it. But you don't compare PB to BMA results. To be honest, one reason I was worried about my results because I have not been 100% compliant with taking my nilotinib.

[MJB]

Thank you Trey for your response. I  also re-read your information about monitoring and it is the trend that is important rather than a comparison..right? I don't have a PCR value from diagnosis. The nurse on the phone yesterday said that they do not have the FISH results back yet. Why would they do a FISH? Standard procedure on a bma?

So glad you all are here with your information, reassurance and support!!

I Forget

[Trey]

Trends are important.  FISH during a BMB/BMA is standard procedure for CML.  If you want to be PCRU, have the PCR blood drawn on a Friday before a hurricane. 

If I had ever told my Mother that "I have not been 100% compliant with......whatever" that would have meant I was a really, really bad boy.  And then you worry about your PCRs.  Take your meds -- don't "forget". 

[MJB]

Too funny Trey and you are right, as always!

I find it interesting that my bone marrow PCR values are about the same as my  blood pre- friday/hurricane PCR results. But since  I am responding as I should, there is nothing to worry about! I'm just not PCRU unless another hurricane hits New York!!

IForget