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My FISH results / New ONC


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#1 cgrave2


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Posted 29 November 2014 - 05:24 PM

Hey all,
I started with a new Hem/Onc in my area. He is worse than my last one! At my first visit, I ask him about my PCR number and he says there's no number ( just like my last ONC) and then tells me that he wishes newly diagnosed patients would not be able to search the internet for info!!!!! Being the gracious southern lady that I am, I didn't say anything! Actually I still get intimidated, even at my age and I chickened out! I was appalled!
So I still don't know my PCR number after 4 years!

On my second visit With him I had a Fish test done and I asked him my results and he said that it was something like .006. Is that a good result?

He also said he doesn't do PCR, just FISh! Isn't the PCR test a more accurate test?
I'm getting closer to going to MD Anderson!

Here is my Fish results-

Component Results
Component Standard Range Your Value
MBCR Specimen Blood
MBCR Specimen ID 975940
MBCR Source Test Not Performed
Corrected result; previously reported as Blood on 06/03/2014 at 11:10.
MBCR Order Date 05 Jun 2014 14:17
MBCR Reason for Referral CML
Corrected result; previously reported as 1 on 06/03/2014 at 11:18.
Locus and probes [Strategy;#nuclei;Class]
9q34(ABL1), 22q11.2(BCR) [DFISH;6000;ASR]
Probe strategy: DFISH=dual color, double fusion.
Abnormality Result %Cutoff
BCR/ABL1 fusion (6000) Normal

#2 DaveL


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Posted 30 November 2014 - 01:39 AM

It seems they looked at 6000 cells and EDIT: can't tell if they found any with bcr-abl1 (CML).... It says normal. Fish tests have some false positives quite often. My onc told me fish is not really accurate below 1% and you need the pcr. Either way, great results if it's what your onc says!

#3 Trey


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Posted 30 November 2014 - 10:14 AM

The FISH says it was "normal" so no leukemic cells found.  


In the report it also says: "Corrected result; previously reported as 1 on 06/03/2014" that means the June FISH report of 1 leukemic cell out of the 6000 cells examined was reinterpreted to be zero. 


PCR should generally be done from the beginning, but as long as the FISH remains positive above approx 2% then PCRs are not as necessary, although still good practice to do them.  But after the FISH drops below roughly 2% (error level for the 6000 cell FISH) the PCR is necessary since it is a far more sensitive test.  A zero FISH is CCyR level, and roughly equal to a 1% PCR.  In this era of TKI drugs the patient and Onc must know how far below CCyR level the patient is to know if the drug is working well enough.


It is possible that you are having PCRs done, but they are the qualitiative (instead of quantitative) PCR.  I say this because the Onc says "there is no number" instead of saying no PCR was done, if your wording is precise.  Ask specifically if a qualitative PCR has been done.  If so, and the result is zero, then that is PCR undetectable (PCRU). 


You can read this for more info:

http://community.lls...l=+cml +testing

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