11 replies to this topic

[Ray99]

I have not posted messages for a while.  But I did read postings on a regular basis.  I have been busy moving from Ohio to San Francisco Bay area.  I am now pretty much settled. 

I went to see a Hematologist in Stanford Cancer Center.   On my first visit in August, it seems that he ordered two PCR tests, one qualitative and one quantitative.  I don't know whether this is a standard procedure or not.  Here are the results of the two tests. 

BCR - ABL, BLOOD - Details

Results

 

Negative
No BCR-ABL transcripts detected by RT-PCR.

Comment

 

BCR-ABL is the molecular equivalent of t(9;22).

Method

 

PCR amplification of reverse-transcribed RNA

Primers

 

Major breakpoint (CML) and minor breakpoint (ALL)

 

BCR - ABL QUANTITATIVE, BLOOD - Details

Clinical Indication

 

Quantitative transcript level determination and minimal residual
disease monitoring in CML/ALL.

Result

 

N/A
Test cancel and credit. See qualitative BCRABL result instead.

P210

 

N/A

log dx avg

 

>3 log reduction

Comment

 

N/A

Method

 

(NOTE)
BCR-ABL mRNA transcripts are detected by a one step real-time RT-PCR.
A control gene (ABL) is amplified as an internal standard. Each
sample is amplified in duplicate for both the target (BCR-ABL) and
control (ABL). Quantification is determined from known calibration
standards provided by Ipsogen. This assay has a sensitivity
equivalent to 10e-4 dilution of a known BCR-ABL positive cell line.

 

I have not got a chance to discuss it with the doctor face to face yet.  But the nurse told me that if the first test is negative, then the second test is usually cancelled since the results would also be negative.

 

I have not heard anybody on this board have this style of PCR tests.  Is this pretty unusual?  How good is the qualitative test?  And what is the cutoff point for "negative" in qualitative PCR test?  Should I insist next time (in about a month) that I would like to have a quantitative PCR test?

 

[gerry]

Mine were a bit different

Early results showed the CML declining, then i got a "positive" Qualitative result, but no numbers, indicating that there was CML there but below the level they reported on. The next test was a negative.

[chriskuo]

What were the test results prior to your Stanford testing?  If I remember correctly, Stanford does not use the International Scale.

[Ray99]

I was diagnosed two and half years ago.  My PCR readings are in the range of .03% - .06% IS for the past year before the Stanford test.  I am kind of surprised to see a negative results.  But, if their reporting cutoff is .01%, then the latest result is not that surprising.

Is the negative qualitative test the same as PCRU?   It is very confusing when changing Lab.

[Trey]

The only time the qualitative (non-percentage) PCR is done after diagnosis is when the patient is PCRU.  In your case the qualitative was done first, determining the PCRU status, so the quantitative (numerical) PCR was canceled assuming it would also be negative.  The reason some Oncs use qualitative PCR is that they believe it is more sensitive.  I don't know if that is true, but it is one reason why it would be used for a PCRU patient.  The other reason is that qualitative can detect several types of CML breakpoints (P210, P190, P230) while quantitative sometimes only looks for P210 (b2a2 and b3a2).  And qualitative negative is certainly PCRU.  Congratulations to you Ray.  Hope all goes well out there in SF.

Edited by Trey, 07 October 2014 - 04:31 PM.

[Susan61]

All I know is that I have been getting a Quantitative PCR test for the past 15 years that I know of. The Script always reads

Q PCR bcr/abl/  Now I am wondering if it has been a Qualitative.  Quantitative sticks in my mind for some reason.

I will have to ask my Oncologist now.

What test do you get Trey?

[Sneezy12]

The Qualitative test is used at the time of diagnosis to detect the presence of all forms of bcr/abl fusions. The Quantitative test is used to follow any decrease in the specific ones that are detected. Refer to The Mayo Clinic Lab website.

[hannibellemo]

San Francisco is my favorite city to visit! Congratulations on your excellent report!

 

Pat

[Ray99]

Thank you all for sharing your thoughts. I am happy with the qualitative PCR "negative" results if that indeed, as Trey said, equal to PCRU.

 

I will ask my Onc in my next visit why he order qualitative PCR first and then follow by quantitative.  It seems pretty unusual based on what I read on this board.  May be that  the standard practices at Stanford Cancer Center.

[TeddyB]

Congrats Ray, great results

[Ray99]

Teddy,

Thanks,
Your recent numbers look pretty good too. Hope it will continue to go lower and eventually negative.

Ray

[TeddyB]

Thanks Ray, i sure hope so too