So I just got my cytogenetics back, the actual report and while it says they looked at 30 cells and found 0 Philly Chromosome and that is was a :"normal male karyotype", my PCR has gone up. My onc wanted to do a PCR along with the BMB to get a baseline of how the two correlated because at 6 months I was at a 1.1 log reduction and cytogentics showed 10% or 2/20. In late November I had a PCR done and it said 1.3 log reduction...Then because of travel issues I had my 12 month bmb early and it showed 0/30 PH+ cells with normal karyotyping and normal morphology and no residual signs of CML. Now my pcr shows a .9 log reduction. I am at GD6PG 0.29...up from GD6ph 0.097%. How can it be that I am at 0 cytogenetics when my PCR is higher than it was when I was at 10% cytogenetics (1.1).....Trey? Phil? Waiting for my onc. to call. -Josh p.s. My dx PCR was 1.1%
The confusion continues....
Posted 30 December 2011 - 03:53 PM
The G6PDH is the control gene. Your lab uses it instead of ABL or some others. The PCR accuracy ( or lack of) is one issue we have discussed before. Otherwise, the PCR can bounce around as the overall numbers of leukemic cells are killed off but the normal cells are not yet ramping up. That can happen especially during the first year. I would suggest that the BMB CCyR is the better indicator. This should be a lesson to others that the PCR is not so accurate as the multiple decimal places might imply.
Posted 30 December 2011 - 05:52 PM
I take it the Cytogenetics is a much more "accurate" test?
Posted 31 December 2011 - 11:03 AM
Much more accurate than PCR. Cytogenetics is like working out the ratio of sheep to goats by counting them. PCR is more like going round the field sniffing the dropping. Celebrate the CCR and don't worry about the PCR so much until you have more of a trend line to play with.
Happy New Year
Posted 31 December 2011 - 11:37 AM
I am not worrying because mathematically it just doesn't make sense. 6 months ago they tested 20 cells and i was at 10 percent..and my OCR was 1.1. Now they tested 30 cells and I am at 0 with a pcr of .9. Coupled with a clean bmb and a good CBC and the fact that just 3 weeks ago my pcr was at 0.097 with a 1.3 reduction I am just assuming this pcr isn't accurate. Maybe it's denial
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