9 replies to this topic

[MJB]

Good morning!

I had the results of my recent bma faxed to me and of course it leaves me scratching my head in confusion! When I called for the results the nurse told me the PCR had been done on the aspirate not PB and not to compare the aspirate results to the previous PB results, the doctor was happy with my results. OK..well, the PCR report says;

Specimens Submitted:

1:Blood (Paxgene)

I know what the Paxgene is but shouldn't the specimen say Aspirate?

My PCRs are;

Jan 2011 by PB - .009

May 2011 by PB- .005

Aug 2011 by PB- .033

Aug Retest by PB - .0001

Nov 2011 by ? - .038

I know these are low levels and I know I shouldn't worry but I hate not knowing! Ya know what I mean? Would I be ridiculous to call the onc for a clarification  of specimen after the nurse made such a point of this result being from the aspirate? Should I just wait till Feb. for my next BP PCR? Any insight and information would be sooo appreciated!

If you're still with me, I also have a question on the Aspirate report. The MD comments say " The M:E ratio is decreased. All cell lineages and stages of maturation are seen. Lymphoid elements are increased." The technologists notes that there are small clusters of Lymphocytes and areas with more (up to 35 %) are seen.  Lymphoid and Monocytic series are reported as High, Myeloid as Low. I do not have a viral infection. Is there anything in this report that I should be concerned about?

Thank you!

IForget

[Trey]

Pretty good results for someone who only takes the drug when they "remember".

PaxGene is just the specimen tube preservative agent, associated with Qiagen Labs.  I don't think that makes any statement about source of the specimen.  If they did not take peripheral blood during the BMB (should not have been done), then the only source would be the aspirate.

Your WBC is low, especially the neutrophils.  So the Lymph side will show as higher by percentage even if low.  That is fairly standard for CML during TKI treatment.

[CallMeLucky]

You shoud call and ask for clarification.  As you know, we use the same lab.  When I had my bome marrow aspirate done, it said

Specimens Submitted:

1. Bone Marrow (Paxgene)

My last PCR, which was on Peripheral Blood said

Specimens Submitted:

1. Blood (Paxgene)

If the lab report shows the specimen was blood then it appears the PCR was not run on the marrow.  Either that or there is a mix up.  Double check the dates to make sure they sent you the right one.

[MJB]

LOL yup, I know right?

They took BP, multiple tubes, when I first arrived as they always do. What color is the top of the tube for PCR? My WBC by CBC was 5.4 that day. Are the neutrophils part of the myeloid series and that is why they  are low?

Thank you Trey for being there and ALWAYS remembering cause you know..

IForget

[MJB]

Thank you Lucky, thats what I thought it should read. I hate calling and pestering them when they are dealing with so many people with critical issues.

Thank you and have a Happy Thanksgiving!

IForget

[CallMeLucky]

You're not pestering them, we have a serious medical condition.  Just because we are not falling over does not mean we are not worth the time.  I have news for you, if you were falling over, they wouldn't do anything for you, they would send you to the ER.  So the reality is that we are clinical patients, which is actually what they deal with, so don't worry about calling them.  The staff there has always been very good about calls so i wouldn't worry about it.  They usually have office hours on Wed so a good day to catch them, especially try before holiday or you probably won't get an answer until Monday.  I don't think there is really anything here to worry about, if I had to bet, I would say they ran the PCR on the PB (I think it is the lavender colored tube for PCR, but not 100% sure).  So your results are low and consistent with the exception of the hurricane one.  They don't seem to get too upset there about PCRs jumping around, she has said to me more than once that unless there is a big jump, she doesn't consider it an issue.  She has also stated that getting to PCRu is not something she looks for because she doesn't trust that you are really PCRu when the test is negative.  So as long as you are low level then it appears to be ok.  Call for peace of mind, but it seems like everything is fine.

Happy Thanksgiving

[MJB]

Good points Lucky!

I am at a very low level and wouldn't worry so much except that they made me re-test immediately when I increased from.005 to.033, now it looks like another small increase to .038 .

This is still less than a 1 log increase?

You know what I am really uncomfortable about?  The possibility that they goofed cause the nurse on the phone insisted that the .038 was from the bone marrow!

Thank you for your understanding!

Have a Happy Thanksgiving!!

[CallMeLucky]

Working with humans is annoying.  As good as the service and expertise are there, sometimes I do feel like it is a bit of a factory.  In many ways it is,so i guess we take some good with bad.  Goes to show no matter what, you have to be an advocate for yourself and keep on top of things. I wouldn't consider .033 to .038 an increase of any kind, they are the exact same number, regardless of what your high school math teacher told you.  The .005 to .033 would appear to be a log increase, but the fact it hasn't continued up, I would think is a good sign, remember we look for trends, so at this point things are jumping around at the low end, but they don't appear to be on an upward slope.  That would be the follow up question just to be sure, but I think you already got the answer when they first called and said the doctor felt everything was fine.  Nerve racking I know, but it appears you are just jumping around at the bottom.

[Trey]

PCR is usually a lavendar top tube.  But PaxGene may use a light red color from what I understand.

http://www.ncbi.nlm....pubmed/18303987

[MJB]

I contacted the Dr. office via the email system and I was right, the results are from BP. The doctor said they will await the bone marrow results because that PCR trumps the peripheral blood results. The bone marrow was taken on 11-7-11, looks to me like they goofed and didn't run a PCR test on it!!

Thank you for all your help and understanding!!

Enjoy the holiday!

IForget