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What is the difference between "inconclusive" and "negative"?


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#1 cfroncz1

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Posted 07 November 2013 - 02:28 PM

My last 2 tests came back as "inconclusive". The doctor says this is good and that it means that the people doing the test can't be sure if they see CML cells, but they also aren't sure if they don't. He says it is not the same as being "negative". I just wonder if there is a better explanation? I find the whole thing confusing? To me...either there are CML cells showing or there aren't?

Thanks!!!
Cheryl



#2 Susan61

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Posted 07 November 2013 - 06:45 PM

Hi Cheryl:  I do not like your doctors explanation, and you are right.  They either see something or they do not.  Was this a PCR test?  I would want more specific answers, and a repeat of the test if needed.  I have never heard of a Inconclusive result.  Maybe someone else has.  Do not accept his answer.

Susan



#3 cfroncz1

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Posted 07 November 2013 - 07:06 PM

Hi Susan, Yes this was the BCR-ABL test. This is the 2nd "inconclusive" I have received. They say it is too small to have a number, but yet not really gone? I don't get it even after they had 2 different people explain it to me. If no one else has heard of this as a result I'm really going to start to wonder what is going on.


Thanks!
Cheryl



#4 GerryL

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Posted 07 November 2013 - 07:55 PM

Hi,

I've add similar comments for my two BMBs, collected by different doctors but reviewed at the same testing lab.

Blood tests still showed CML at the time. I've no idea what was going on the with BMBs.



#5 Trey

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Posted 07 November 2013 - 10:03 PM

FISH and BMB are actual counting of leukemic cells in a sample.  PCR is a process to grow DNA/RNA fragments and then compare them to other fragments.  When a process is inexact, you need inexact terminology to describe the outcomes.  The PCR results are provided as a percentage, but it is not a percentage of leukemic cells in the body.  Rather, it is a percentage of BCR-ABL RNA strands to another normal RNA strand found in the white blood cells.

If a PCR were an actual count of leukemic cells (actually BCR-ABL RNA chain sequences) then there would be no such thing as "inconclusive", or "below detectable limits", or "kinda sorta looks like....".  But a PCR is an estimation of the amount of BCR-ABL and from the leukemic cells in the sample, and there is a fair amount of uncertainty.  It is an estimation since it takes a sample of blood or marrow, puts it through multiple sequences of deconstructing the DNA and growing new DNA/RNA, baking and shaking, denaturing and renaturing, etc.  At some point the lab equipment says "time is up" and the process is ended and the BCR-ABL is compared to the amount of ABL (or other control gene) in the sample.  If no BCR-ABL is found, it is undetectable.  If the test shows a very low level of BCR-ABL, then it may be a false positive, so it is below the cut-off for accurate detection.  It is labeled "inconclusive" or "below limits" or whatever. 



#6 cfroncz1

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Posted 08 November 2013 - 04:26 PM

Hi Trey, Thanks for the info. This makes more sense to me. I guess I need to realize that this test isn't perfect!  It is hard to accept coming from a perfectionist.

Thanks,
Cheryl



#7 Trey

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Posted 08 November 2013 - 09:21 PM

"Perfectionism walks, while healthy striving rides."

--Trey

http://cmhc.utexas.e...fectionism.html






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