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#1 cam_kris

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Posted 26 October 2012 - 03:53 PM

Hi Everyone!

Well I am back with my 6 month check up~ Being on  600 mg Tasgina a day

I am extremely happy as for my Dr. told me that I have reached Minor Molecular Response

he said I am at 1 log

the fish test wasnt back yet but the nurse called me today.  she said that the fish tests was positive and he isnt worried  but he will retest it in 6 weeks.  she said my test

showed 0.08

Could someone please tell me what the fish test will tell us, what is normal and if this is anything to worry about? the nurse didnt seem to know much about this,

  I had him write what was my last fish test and he said it was 1.47 on July 24th  well, isnt that good to go to down to 0.08?

Im a little confused here.

Here are some results

Total cells counted 300

Erythrocyte Precursors 22%          Blasts 1%          Promyelocytes 3%     Myeloctes 7%     Metamyelocytes 13%     Band Neutrophils 9%

Segmented Neutrophils 18%          Eosinophils Precursors 1%          Basophils Precursors 0%       Monocytes 4%          Promoonocytes 0%      Lymphocytes 21%

Plasma Cells 1%          Other 0%     Lymphocytes 30%      monocytes  5%          Neutrophil segs 60%    Eosinophils 3%          Basophils 2%

Leukocytes are normal

platelets are normal

it states No definitive particle are present to assess cellularity.

Unilaeral decalcified core biopsy and clot section show 30-40% cellular bone marrow with normal numbers of megakaryocytes.  No clusters of immature cells is seen

Thank you for your response!!

Kris



#2 Trey

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Posted 26 October 2012 - 06:26 PM

You need to sort out some information.  First, FISH is reported in  percentages, and does not report below 1%.  So I assume you are talking about PCR test results, not FISH.  That is the only way your results would make sense.  Read more here:

http://community.lls.org/docs/DOC-1273

Your log reduction depends on the lab standards, whether International Standard (IS) or regular.  The 1 log reduction seems too little based on your PCR results, but since I do not know your lab standards, I cannot say for certain.  But the drop from the July PCR to the latest PCR is more than a log just by itself, so your total log reduction since diagnosis must be significantly more.  Maybe your Onc saying you had a 1 log reduction meant since the last PCR?  The more important issue (and less confusing one) is telling the patient the total log reduction since diagnosis.  The other possibility is that the lab standard log reduction uses the non-IS scale and starts with a low number, so your actual total log reduction could be over 2 logs but using the lab standard as the method of calculation it might only be approx one log reduction.  Just speculating, but this can happen.

You are receiving very poor communication from the Onc's office, and the nurse appears clueless.  Talk to the Onc directly and get some straight answers. 



#3 cam_kris

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Posted 26 October 2012 - 08:10 PM

ok thank you!



#4 cam_kris

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Posted 26 October 2012 - 08:12 PM

Trey

when you say lab standards is that just the regular CBC lab report?



#5 cam_kris

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Posted 26 October 2012 - 08:30 PM

WBC 6.83 83x10*3/ul         RBC 4.22x10*6/ul          Hgb 11.5 g/dl          Hct 35.9%          MCV 85.1 fl          MCH 27.3 pg

MCHC 32.0 g/dl          RDW 14.9%          Plt 216x10*3/L

These numbers with the all the numbers and letters behind the test Not a clue what it means.

I do have to talk to him again, esp on the last testing, So do you understand these numbers?   does it tell you anything that could put some light on it?

Thank you

Kris



#6 Trey

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Posted 26 October 2012 - 08:33 PM

No, just PCR.  PCR reporting is either International Standard or not.  If not, the lab is supposed to have a standardized (average) log reduction formula.  But that formula may be way off from your actual log reduction experience. 



#7 Trey

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Posted 26 October 2012 - 08:52 PM

Those are just CBC numbers.  You need to ask your Onc some questions:

1) Was my recent .08 result a PCR?  If so, is that a percentage or ratio? 

2) How was my log reduction calculated -- did the lab report it?  Is it International Standard or not?  What is my total log reduction since diagnosis?

By the way, I forgot to answer your question about the "300 cells counted" question.  That appears to be a Flow Cytometry test result. 






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