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Help me understand FISH


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#1 sarahboxley

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Posted 15 March 2013 - 01:16 PM

I had my 6 month bmb on Monday, and my onc called today with some preliminary results. The lab is apparently taking their sweet time, so I will not have my PCR or my full chromosome test until next Wednesday or Thursday. Even my onc was "displeased", and he is incredibly diplomatic!

Just FYI I take 600mg of Gleevec daily, and I think I have been fairly lucky so far with side effects. I have occasional muscle cramping, and I definitely get hit by the Gleevec fog a couple of days a week. My CK has been borderline high (between 300-400) in the past 6 weeks, but I am not symptomatic, so they are just keeping an eye on it. Here are my results so far:

Diagnosis -      PCR 71.5%          16/20 chromosomes positive (80%)

3 mo -             PCR 1.83%          2/20 chromosomes positive (10%)     FISH 4.5%

I do not remember my onc ever mentioning my FISH scores before, but he told me today that my FISH was negative (it was 4.5% at 3mo, which I don't remember hearing at the time). He explained that this is certainly good news, but that it does not guarantee that my chromosomes will all be negative. I would assume that it is certainly a good thing that this test is now negative and everything is moving in the right direction.

Could yall help me understand how much emphasis to place on FISH? I am just trying to put all of the pieces into perspective as I move through this disease. I don't want to over-celebrate a negative FISH, but I don't want to assume that it is no big deal either. Typically I don't have a problem understanding medical tests and results, but I am having a hard time putting all of the pieces together these days. (Can I blame the Gleevec?? Ha!)

Many thanks for your help and support.



#2 Trey

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Posted 15 March 2013 - 10:49 PM

FISH is probably a better indicator than PCR early on.  A zero FISH is CCyR, which is the 12 month goal.  So that would mean you are ahead of schedule.  Zero FISH is also a good predictor of zero BMB chromosome analysis, so it should be 0/20 now. 

You are doing well.



#3 sarahboxley

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Posted 16 March 2013 - 09:39 AM

Trey,

Thank you for all of your help - don't know what we'd do without you on this board!



#4 CallMeLucky

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Posted 16 March 2013 - 10:50 PM

A negative FISH is a big deal and worth celebrating.  Basically it means they are unable to detect any Philadelphia chromosomes in you blood.  You have a achieved a complete cytogenetic response.  Depending on how you look at it many would say CCyR is the most important milestone in terms of overall survival.  Your PCR test will likely be detectable but that is fine given how long you are on treatment.  For now you are ahead of the curve and fast responder is another good indicator of a favorable long term prognosis.  The battle is certainly not over but this is a very big deal and you should be very pleased.  Congratulations.


Date  -  Lab  -  Scale  -  Drug  -  Dosage MG  - PCR
2010/Jul -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 1.2%
2010/Oct -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.25%
2010/Dec -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.367%
2011/Mar -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.0081%
2011/Jun -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0%
2011/Sep -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.00084%
2011/Dec -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0%
2012/Mar -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.004%
2012/Jun -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0%
2012/Sep -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0%
2012/Dec -  MSKCC  -  Non-IS  -  Sprycel  - 100 - 0%
2013/Jan -  Quest  -  IS  -  Sprycel  -  50-60-70  - 0%
2013/Mar -  Quest  -  IS  -  Sprycel  -  60-70  - 0%
2013/Apr -  CUMC  -  Non-IS  -  Sprycel  - 50 - 0.036%
2013/May -  CUMC  -  Non-IS  -  Sprycel  - 50 - 0.046%
2013/Jun -  Genoptix  -  IS  -  Sprycel  - 50 - 0.0239%
2013/Jul -  Genoptix  -  IS  -  Sprycel  - 70 - 0.0192%
2013/Jul -  Genoptix  -  IS  -  Sprycel  - 70 - 0.0034%
2013/Oct -  Genoptix  -  IS  -  Sprycel  - 70 - 0.0054%
2014/Jan -  Genoptix  -  IS  -  Sprycel  - 70 - 0.0093%
2014/Mar -  Genoptix  -  IS  -  Sprycel  - 100 - 0.013%
2014/Apr -  Genoptix  -  IS  -  Sprycel  - 100 - 0.0048%
2014/Jul -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2014/Nov -  Genoptix  -  IS  -  Sprycel  - 100 - 0.047%
2014/Dec -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2015/Mar -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2015/Jun -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2015/Sep -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2015/Dec -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2016/Mar -  Genoptix  -  IS  -  Sprycel  - 100 - 0.0228%
2016/Jun -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2016/Sep -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2016/Dec -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2017/Mar -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2017/Jun -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2017/Sep -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2017/Dec - Genoptix  -  IS  -  Sprycel  -  100 - 0%
 

 





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