10 replies to this topic

[OhRose]

Hello everyone. My lab has just switched to IS calculations for BCR/Abl testing. I am lost with the results. My last result in May was 0.079 but it was not IS. Now Quest Labs have switched over to IS and my result last week was 5.081%. My Dr says it is a good result but it sounds like so much. How do they figure these results? What is the formula?  I know each lab has it's own conversion factor number. Does anyone have a simple explanation for me?? Do they base it all on your original dx number?? It was explained to me but I am confused now. Was 0.079 actually 7.9% on the IS?  HELP..and thanks.

[chriskuo]

What you need for each result is the log reduction.  The log reductions may not be exactly comparable, but at least

you will be comparing apples and apples, more or less.

[Trey]

Quest Labs has significantly changed their BCR-ABL PCR testing effective August 2012.  The new tests will not correlate with the previous test numbers unless the patients have the log reduction numbers associated with the old  tests.  Many patients will be affected by this change since Quest is such as large diagnostics lab in the US. 

http://education.que...s.com/faq/FAQ72

You asked:

"Was 0.079 actually 7.9% on the IS? "   No.  The conversion factor is not so simple, and is different for each lab.  I could not find the new Quest conversion factor.  But it might possibly be listed on your PCR report.

Look at this other posting about this issue:

http://community.lls.org/thread/16844

[OhRose]

Thanks, Trey. "Signifcantly changed" is what my numbers were for sure. I did call Quest and could not get anywhere. They gave me a speech about HIPPA laws and I tried to tell them this was not a personal info call but I just wanted to kmow what their conversion factor was. I may try again and keep at that. I was at a 3-log reduction on old results. Have not received my copy of test results yet. Will let you all know if conversion factor is on my report. Again, thanks to bo9th for your replies.

[pamsouth]

OHRose,

When GenPath, changed over to the IS, my PCR shot up about 40 to 50 %.  Had a repeat done and they went down to 13 %.  But Gen Path had recorded a PCRU for about 5 years, so go figure.

Any how I did call the lab, at first they didn't want to tell me anything, just talk to your doctor.  But I pressured them by saying I just want to know if you have changed over to IS, and the answer was yes.  I was a bit upset in that nothing had really change about my CML, and the onc had scared me to death.  Then I got a letter from Novartis they weren't going to help anyone with co-pay that were on Gleevec.

Anyhow I was going to an oncologist that sent my labs from Indiana to Gen Path in N.J.  I since have oncologist where they do all their own labs, FISH, PCR, ETC.

PamSouth

[OhRose]

Unbelievably, my blood goes from SW Ohio to San Juan Capistrano, Calif !!!  I really like my doc but hate this blood travel thing. It is an insurance issue. How much do they/I pay for this kind of specialized travel of blood??  It is overnighted..expensive for sure

[pamsouth]

OhRose, 

I don't know if it is always an insurance thing.  At least it wasn't for me.  The oncologist I was going to did not have rights at other local labs that do FISH AND PCR.

I asked my previous oncologist if there was someplace local to send my labs to she said NO.  But after checking around I found out that Indiana University Simon Cancer Center did their own lab FISH/PCR/ETC.  and they are less then 15 miles from my home.  I called my insurance company before switching over to make sure they were in my network and yes they were.   The oncologist there said what my previous oncologist meant, was she did have rights there at I.U.  So did she not know?

I recently saw a video of how packages are handle at UPS.  UPS short handed and those package get tossed around.  I also read how blood can be easily tainted and sometimes labs to do not get to them in a timely manner.  Actually sometimes I think the FISH may be more accurate.  I don't know that to be a fact.  But sometimes I call in to see if my labs are back and the FISH will be done but not the PCR.

I do remember when my PCR went up at Gen Path, my previous onc kept saying much room for error on these PCR as they are magnified over and over.  I would say, then why would you want to base changing TKI on something that has much room for error, and my FISH have stayed the same.  Just food for thought.  I sometimes think we get to upset on these PCR test they fluctuate up and down.   Anyhow I am glad I did not change TKI based on those PCR test.  My fish has stayed the same for 7 years CCRY.  I am happy just to be stable and my other CBC lab close to a normal range.

PamSouth

[OhRose]

I had already gone to the Quest site, Trey, but it does not help me understand my new numbers. Guess I need to make Dr appt and hash this over with him so I will feel reassured about all of this. Also, will discuss a closer lab. Indiana for sure would be closer. I may check that out with my insurance but it could be a thing where the Compunet lab doing my regular CBCs uses Quest as their lab for PCR testing.  What a tangled web.

[pamsouth]

OHRose

Reg >What a tangled web.<

Do you remember the days when insurance was so much simpler?  Maybe that was because in my younger days I was healthy.

We had one insurance card for everything, and you and the provider knew what it paid and didn't pay.  I mean you could expect certain things on a regular annual basis.  Preventive care, Ambulance, ER, Broken leg paid for, etc.

I guess at that time I wasn't testing the waters for a chronic catastrophic illness.  Now you have to be your own advocate for everything or learn thru the grapevine.

I least we have this website and electronic gadgets.   Don't need all those encyclopedia anymore.  Just take your laptop or iphone, or ipad with you and bingo, instant answers, or at least somewhere to start.

PamSouth

[Trey]

The conversion factor might be on your PCR report, so you need a copy of it.

[OhRose]

Thanks all. I will let ya know when I get my copy of testing. It does have me concerned. I was hoping for a simple formula to soothe my mind.