I managed to speak with the doctor who signs my PCR lab reports. He explained to me how his lab (M.D. Anderson) reports the bcr-abl1/abl1 ratio.
Quantitative real-time PCR analysis was performed on reverse-transcribed
RNA from this sample for the BCR-ABL1 fusion transcripts resulting from
the t(9;22)(q34;q11.2) in Leukemia. This multiplex assay is designed to
detect common BCR-ABL1 fusion transcripts e13a2(b2a2), e14a2(b3a2) and
e1a2. The fusion transcripts are differentiated based on the size of the
PCR product using capillary electrophoresis. BCR-ABL1 and ABL1 transcript
levels are detected simultaneously and quantitative results are expressed
as the percent ratio of BCR-ABL1 to ABL1 transcript levels. This ratio
may vary up to one-log because of methodological reasons. The sensitivity
of detection of BCR-ABL1 transcripts by real-time PCR is between 1 in
10,000 and 1 in 100,000.
The transcript I have that was detected is the b2a2 BCR-ABL1 fusion transcript coding for the 210kDa BCR-ABL1 fusion
The level as reported on my file is 0.01 (M.D. Anderson scale which is a higher number than the international scale - why? I didn't ask). He told me that his measurements report to 4 decimal places, but that the last two decimal places are not shown. If his test shows 0.005 it is written as 0.01 if his test shows 0.0049 or less, it is written as < 0.01 and if his test shows 0.015, then it is written as 0.02.
They do not report PCRU as "undetected" unless his test shows no detection by his testing (0.0000). If they see any detection (0.0001) then it is listed as <0.01.
So ... my level is less than or equal to 0.0199 and greater than 0.0050 with a one log method variation. I am very close to being in the noise of their equipment if not there already.
In order for me to do my next experiment (i.e. stop Dasatinib), I need to see a lab report where my PCR is listed as "<0.01". When that happens and I can hold it for a subsequent test, then I will begin my cessation personal trial. At this rate, it will be year-end at least before I get to try and that is assuming I can get below 0.005. What a psychological game.
Diagnosed 11 May 2011 (100% FiSH, 155% PCR)
with b2a2 BCR-ABL fusion transcript coding for the 210kDa BCR-ABL protein
Sprycel: 20 mg per day - taken at lights out with Quercetin and/or Magnesium Taurate
6-8 grams Curcumin C3 complex.
2015 PCR: < 0.01% (M.D. Anderson scale)
2016 PCR: < 0.01% (M.D. Anderson scale)
March 2017 PCR: 0.01% (M.D. Anderson scale)
June 2017 PCR: "undetected"
September 2017 PCR: "undetected"