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#1 pamsouth



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Posted 19 June 2012 - 10:47 PM

Trey would you care to interpret this.  You only need to interpret the last Fish and PCR, I JUST THRU in some of the others to show that even though this is high it is a consistent range on the FISH for over 6 years.  Thanks, pam

Blood collected on 6/7/2012,

FISH 6/12/2012 23:59,


Diagnosis, Evidence of BCR/ABL 1 Fusion by FISH Analysis.

Two hundred nuclei were examined and 13 nuclei (6.5%) demonstrated evidence for two fusion signals. 

nuc ish 9q34 (ABL1x3), 22q11.2 (BCRX3) (ABL1X3), 22Q11.2 (BCRX3) (ABL1 CON BCRX2)  [13/200]

This result is consistent with BCR-ABL 1 rearrangement in approximately 6 % of cells examined.


NUC ISH 9Q34 (ASS x 2, ABL 1 X 3) , 22Q11.2 (BCR X 3 ) (BCR con ABL 1 X 2 ) (3/200)

  June 15, 2012   PCR REPORT p210 BCR-ABL Bid Qn

Transloc Bid Ql PCR, DETECTED. %IS 8.496  %is  (<=100,0000)

PCR 3/23/12, P210 bcr-able Transcripts Bid  %IS 7.623 (<=100,000)

THIS IS A RESEARCH USE ONLY (RUO) assay.  It has not been cleared or approved by the U S Food & Drug Adm. The reagents used in this assay are not diagnostic tools. The results obtained from this assay, if used in a clinical setting, should only be interpreted in support of clinical diagnosis.

The above test is my second lab run at I.U.

My previous labs from 2005 to 2011 were ran at Gen Path in New Jersey.  I have a few of them in front of me.  I think my lab behoves the oncologist and the labs.

FISH;  At Gen Path, N.J.

1.  3/3/11,  FISH 92.3 % normal,  7.7 % Positive Nuclei with single fusion.  Probe Info Type Dual color/Dual Fusion NUC ISH(ABL1,BCR) X 2[300],

At bottom of report it has pic of the BCR/ABL and says 2 green bcr & 2 red abl signals (x1000)

2.  6/25/10, FISH 96 % Normal Nuclei, 4% positive nuclei with dual fusion.  PROBE INFO  Type Dual Color / Dual Fusion nuc ish (ABL1X3) ,(BCRX3), (ABLCON BCRx2 [15/300] .  At bottom of report it has pic of bcr/abl and say one green BCR & one red ABL and two yellow fusion signals x1000.

3.  2/16/10, FISH, 100 % Normal Nuclei.  PROBE INFO NUC ISH (ABL1,BCR) x2 [300]

However further down the report is a picture of the bucr/abl and it says Two green BCR and two red ABL  signals (x1000) so I don't know why the results says 100 % normal.

4.  8/28/09, FISH 100 % Normal Nuclei.  Probe Info Type Dual Color /Dual Fusion nuc ish (ABL1,BCR) x 2 [300]. 

Then there is a pic and under the pic is says 2 green bcr & two red abl signals x1000

PCR RAN AT GEN PATH were pretty much Not Detected from 2005 until Feb 2011 when Gen Path changed over to IS.  I did call LLS to help to read the last two reports at they went as high as b2a2 23.45% and b3a2 23.45 % , then a week later dropping to b2a2 Not Detected and b3a2 12/12 %

Gen Path did rerun some of the PCR through out as sometimes my FISH were positive.  In Univ was stumped at Gen Path reports as well that some of the PCR were PCRU while the FISH WAS positive.  So I.U. ran some test to see if I had other mutation, but none showed up, only the BCR/ABL.

It is getting late, I am tired, I hope that the above made sense and my figures were typing the right numbers and dates.  I did review and edit.



#2 Trey


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Posted 20 June 2012 - 09:29 AM

Your FISH was zero (CCyR) in the 2009 timeframe, then has been low positive since early 2010.  I would be surprised if your PCRs were truly "not detected" from 2005 through 2011, and you should get copies of the reports going back as far as you can.  There is a possible cause for this confusion.  You have two breakpoints, both b2a2 and b3a2 which occurs in a very small number of CML cases.  When a person has two breakpoints, sometimes the PCR report can be mis-read when one of the two breakpoints says "not detected" but the other is positive.  The Onc or nurse may have seen the "not detected" and misinterpreted the report as meaning the entire PCR was not detected, but the two breakpoint values must be added together to get the true result.  This could be a possible explanation.

The picture of red & green dots is just reference material and not your individual result. 

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