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Trey, please help with first lab results....


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#1 Txmom.4

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Posted 17 December 2011 - 01:22 PM

Ok, I have looked at these numbers, not sure what all this means:

Initial diagnosis bcr/abl results:

bcr/abl t(9,22) 28.219

bcr/abl to abl ratio -0.835

12/12/11 bcr/abl results:

bcr/abl t(9,22) 0.068

bcr/abl to abl ratio 1.783

I think the 0.068 looks like it is a good drop, but the ratio going from negative to a positive? 

I appreciate all of the information you provide for everyone, thanks again, I will learn all this eventually, meet with my doctor week after Christmas and these are the first results since my initial diagnosis.



#2 Trey

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Posted 17 December 2011 - 05:26 PM

It looks like the results have gone in the wrong direction, from the information you have provided.  The ratio has gone up, so from what I see here, the PCR number is rising unless you have not written it as it appears on the reports.  I don't know what the other numbers are (28.219 and .068) but they do not appear to relate to the ratio.  Also, the ratio has not "gone from negative to positive" -- it went from less than one to more than one.  Only "zero" is negative on a PCR.



#3 Txmom.4

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Posted 17 December 2011 - 05:41 PM

Well hmmm....I guess I have a lot of questions for my doctor ....he was out of town last week, hopefully I looked at things wrong on the lab report.   Thanks for your help!



#4 Txmom.4

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Posted 17 December 2011 - 05:53 PM

So question, if I did write it down right, why have my wbc's gone down from 79 to 7? Sorry, just confused a bit, don't have your knowledge or experience with numbers! Thanks again!



#5 Trey

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Posted 17 December 2011 - 06:12 PM

WBC and PCR results do not necessarily correlate.  A patient can have a low PCR number but high WBC, or low WBC and high PCR.  The PCR estimates the amount of leukemic WBCs in the blood sample it is given.  If a person has low WBC, the percentage of leukemic cells can still be high, so the PCR can be high.  So your WBC has dropped to normal, but your PCR appears to have risen.  That would imply that you have fewer WBCs, but more of them by percentage terms are leukemic.  This can sometimes happen early in treatment because the more leukemic WBCs are killed off, the tougher it is to kill the remaining ones.  This is because the drug is working it way through higher and higher levels of leukemic WBCs, and the higher in the chain they are, the harder they are to kill. 



#6 Txmom.4

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Posted 17 December 2011 - 07:09 PM

So it isn't necessarily bad right now, and The doctor will hopefully let me stay on sprycel?  I just wanted to see how worried I should be or not be.  I still am a bit overwhelmed with all of this. Thanks!



#7 PhilB

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Posted 19 December 2011 - 09:12 AM

Hi Txmom,

The bad news is that your lab have invented yet another daft way to report results.  The good news is that you are doing well

Your initial thought that the drop from 28.219 to 0.0068 was a good one is correct.  The other numbers have successfully confused even the mighty Trey.  What they represent are log reductions relative to 'standard'.  Your initial results were about 7 times higher than the lab standard - which works out as 0.835 log over standard.  Your new results are about 61 times lower than the lab standard or 1.783 log reduction from standard.

Why they have decided to report log increases (which are positive numbers) as negative and log decreases (which are negative numbers) as positive is between them and their psychiatrists.

The proof of the numbers is that your overall reduction is 0.0068/28.219 = 2.618 log and 0.835 + 1.783 = 2.618 which is great news.

Happy Holidays

Phil



#8 tiouki

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Posted 19 December 2011 - 09:22 AM

Hi taxmom,

A decrease from 28.219 to 0.0068 is excellent news You are close to MMR !



#9 Trey

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Posted 19 December 2011 - 11:31 AM

I hope Phil's inputs turn out to be correct.  I initially thought the same as Phil except that the use of the phrase "bcr/abl to abl ratio" in a PCR report is only used in one way, so if the phrase is used correctly my input would be correct, although I ignored the negative sign as an artifact.  But if "bcr/abl to abl ratio" is mis-used and somehow meant to say "log reduction" (would be extremely poor use of the Queen's English) then Phil is correct.  You need to ask your Onc to verify, because the lab report is not written using standard terminology or format.  (Note: Phil has a typo .0068 vs .068, which confused tiouki but did not affect his analysis).



#10 Txmom.4

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Posted 19 December 2011 - 09:28 PM

I sincerely thank all of you for input!  No offence Troy, hope Phil is right!  I even hate to say that because you especially, have given me such useful information and given to everyone for that matter!  I cant even imagine how many hrs it took! My grandma used to say someone would be earning jewels in their crown for those who did good deeds.  I think you absolutely will for all of the help you give out! Everyone here has been awesome to help the newbys, especially during what is such an overwhelming time!  I will ask my oncologist ( appt after Christmas )  & we shall see who is right I guess!  Even if you are right Trey (wouldn't  surprise me seeing your vast knowledge) maybe the thing about that sometimes happens during early treatment will apply.  Thanks again to all! 



#11 PhilB

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Posted 20 December 2011 - 06:26 AM

I think we can be pretty confident in the analysis I did as the numbers tie up to three decimal places.  Having said that, I only got there by ignoring the words entirely which, as Trey points out, are utter tosh.

I don't know about jewels in crowns, but Trey has certainly earned a phenomenal number of potential free drinks all around the world.  We'll have to persuade him to go on a world tour when he retires - although I suspect he'd spend most of it drinking chocolate martinis in Tedsey's basement!



#12 Trey

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Posted 20 December 2011 - 11:10 PM

I believe that Phil is correct...just this one time.  I bet that Herodotus helped with the analysis, given that he is a JIve Genius.

PCR obfuscation causes me off-urinations:

http://www.cancernet...e/10165/1570782

I don't dilute my Martinis with cocoa squeezin's. 



#13 Txmom.4

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Posted 21 December 2011 - 10:55 AM

I am glad you guys agree!  Good news for me!  I see dr next week and looking forward to hearing him agree too!!! 






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