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PCR: peripheral blood vs bone marrow

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#1 dchicago



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Posted 15 December 2014 - 08:28 PM

Hello fellows,


It's been a year since I was diagnosed.  I read this forum almost every day, but hardly posted anything.  I do appreciate the wealth of information and emotional support this group provides.  Thank you!


I just got my BMB and PCR results back for my one-year check up.  One thing I don't quite know how to comprehend is that my Onc did PCR on both my blood and my bone marrow sample.  Blood: 0.01% IS, bone marrow: 0.1% IS.  I don't know how to interpret this 1 log difference between the results done by the same lab on samples drawn on the same day.


I'm slightly disappointed at the results given my blood PCR were negative 3 months and 6 months ago.  I understand PCR is not really as precise as the decimal points suggest.  I told myself not to get too attached to the previous 2 undetectables.  And I know being in MMR within a year is a good place to be.  However, being an over achiever, I don't like the bone marrow PCR being right at the MMR mark.


I'm meeting my Onc soon to discuss the results.  I'm hoping you guys can give me some insight on this.



#2 Trey


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Posted 15 December 2014 - 09:27 PM

That is a larger variation than would normally be expected, but I would not base any conclusions on that alone. Mayo Clinic says:

"Blood is the specimen of choice for monitoring. While most patients show similar bcr/abl levels in blood and bone marrow drawn at the same time, some patients have a consistent difference in the levels in blood and bone marrow such that alternating specimen types during monitoring can lead to confusion."



It is not clear that International Standard should be applied to bone marrow samples since the standardization is based on peripheral blood.

#3 dchicago



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Posted 15 December 2014 - 11:18 PM

Thanks, Trey. I will find out how my Onc interprets the results, and what the significance of the PCR on the bone marrow this week.

#4 Calvink669


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Posted 25 December 2014 - 01:20 PM

I had an experience that is just the opposite. I am a patient of Northwestern Robert Laurie Cancer center, and was diagnosed last October with WBC of 550k and initial PCR of 176%. By May I was down to .76 and was really happy. Then at end of July my PCR came back at 2.53 however the Dr and myself thought that was odd and repeated the next week and it came back at .73. They think there was an error in the lab results for whatever reason. This of course doesn't give me a lot of confidence in the PB PCR results at this hospital. Then at the end of October my PB PCR comes back at 1.03 and the Dr orders a bone marrow biopsy to check where I'm at from a cytogenetic stad point and check for mutations. I get the biopsy done 2 weeks to the day from when the PB PCR was taken that came back at 1.03. The results from the biopsy came back as CCyR. So obviously they couldn't do a mutation test however they did a PCR from the marrow and that came back as .19 (IS).

Needless to say this whole ordeal was pretty stressful and all because the PB PCR appears to not be accurate. I'm at the point where I've lost confidence in the PB PCR tests at northwestern.

Just sharing my interesting results.


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