Jump to content


Photo

Help understanding PCR test results?


  • Please log in to reply
7 replies to this topic

#1 alc999

alc999

    Advanced Member

  • Members
  • PipPipPip
  • 37 posts

Posted 05 February 2015 - 03:48 PM

I'm hoping someone can help me understand my PCR test results? Just preliminary diagnosed last week based on a 220K WBC. This week my PCR test results came back positive for the BCR-ABL gene. And my b2a2 transcript is 195%. I know this means I have only the b2a2 transcript (e1a2 and b3a2 were negative), but what does the 195% mean? My oncologist kind of brushed it off when I asked - saying that the way these percentages are reported are confusing. 

 

And as a follow up to a question I posted a few days ago asking if I could be diagnosed without a bone marrow biopsy...I talked to my doctor about that also and he said that the blasts in my blood were only at 1%, so he considers me in chronic phase and he doesn't see a need to do a BMB.

 

I'm starting 400mg Gleevec today, which I'm glad for.


01/15: Diagnosed, 195% PCR, 100% FiSH, Began Gleevec 400 mg per day

04/15: 58.1% PCR

08/15: 1.6% PCR, 0% FiSH

11/15: 0.6% PCR

02/16: 0.4% PCR

05/16: 0.1% PCR

09/16: 0.3% PCR, Began Gleevec 600 mg per day

12/16: 0.1% PCR

03/17: 0.2% PCR, Began Tasigna 600 mg per day

07/17: 0.08% PCR


#2 Trey

Trey

    Advanced Member

  • PS Beta Group
  • PipPipPip
  • 1,705 posts
  • LocationSan Antonio, Texas

Posted 05 February 2015 - 06:18 PM

Several years ago there was an effort to standardize PCR results across labs.  The reason is that "raw" PCR numbers can vary widely among labs, since they use different equipment and chemical reagents to perform the test.  So patients (and Oncs) had a hard time figuring out the status, except they used PCR reduction from the diagnosis PCR result as a measure of progress.  So the International Standard (IS) was developed to try to standardize PCR results.  The IS system uses 100% as the standard PCR for CML patients at diagnosis, and so 1 log reduction is 10%, 2 log is 1%, and 3 log reduction (MMR) is .1%

 

So your 195% says your PCR is 95% higher than average 100% at diagnosis. 

 

Regarding not doing a BMB at diagnosis, our new member CWAD would have no idea about his additional mutations except for the BMB showing them, which led to his specific additional testing. 

http://community.lls...-to-transplant/

 

Something to consider.  Your Onc does not understand this issue, unfortunately.  You certainly have CML, but you don't know if there are additional mutations, and you don't know the "morphology" of your marrow.


Edited by Trey, 05 February 2015 - 06:21 PM.


#3 alc999

alc999

    Advanced Member

  • Members
  • PipPipPip
  • 37 posts

Posted 05 February 2015 - 06:41 PM

Thanks so much Trey for explaining the PCR. It doesn't sound like that percentage is very good!

 

I'm uncomfortable with the decisions being made by the oncologist I'm seeing (he's just who my GP sent me to last week when my WBC came back high during a routine check up). So I have made an appointment with another oncologist who specializes in leukemia at our University Cancer Center. Unfortunately, the first "new patient" appointment I could get was in March, but at least I'll be on Gleevec and be being monitored until then.


01/15: Diagnosed, 195% PCR, 100% FiSH, Began Gleevec 400 mg per day

04/15: 58.1% PCR

08/15: 1.6% PCR, 0% FiSH

11/15: 0.6% PCR

02/16: 0.4% PCR

05/16: 0.1% PCR

09/16: 0.3% PCR, Began Gleevec 600 mg per day

12/16: 0.1% PCR

03/17: 0.2% PCR, Began Tasigna 600 mg per day

07/17: 0.08% PCR


#4 Trey

Trey

    Advanced Member

  • PS Beta Group
  • PipPipPip
  • 1,705 posts
  • LocationSan Antonio, Texas

Posted 05 February 2015 - 07:18 PM

Good decision.  Oncs who avoid proper procedure, taking unnecessary risks on behalf of their patients, are not worthy of continued confidence.  For me, I would want to know that the BMB actually shows what your Onc "assumed".  Most times there are not additional issues.  But sometimes there are.

 

Your PCR and WBC were both above the average for diagnosis.  The highest diagnostic WBC I heard of was about 700K, but average is closer to 100 - 150K.  But the real key is how well the TKI drug works for you.  For most patients the drugs work well so stay focused on that thought.



#5 chrissy778

chrissy778

    Advanced Member

  • Members
  • PipPipPip
  • 177 posts
  • LocationTroy, New York

Posted 06 February 2015 - 11:18 AM

alc999, if it helps my white blood count was 229.000 at diagnosis. I was diagnosed a year and a half ago and am on Gleevec 400mg and am doing well. I have had two bone marrows one the day after diagnosis. I have B3a2 I do not know what it was at diagnosis but my PCR at 4 months in was 3.457 I am now 0.054 I was diagnosed through routine blood work at a yearly exam through my regular Drs office. Like most of us on here I did not know I was sick and was in denial at the time I was told. I realize now I did seem a little more tired and got out of breath or winded more easily then. I don't feel like that as often anymore. I know you are scared, I was terrified and still have days I am scared. All I can say is you will be ok...and you are not alone


Its never to late to live happily ever after/ Do not squander time; for that's the stuff life is made of


#6 alc999

alc999

    Advanced Member

  • Members
  • PipPipPip
  • 37 posts

Posted 06 February 2015 - 11:33 AM

Thanks Chrissy! I do think I'm somewhat in denial and shock. But I'm trying hard to be positive, and it helps to hear positive things on this board!

 

On a side note, I see you're in Troy NY...I grew up down the road in Burnt Hills and my parents are still there. I live in Tucson now though.


01/15: Diagnosed, 195% PCR, 100% FiSH, Began Gleevec 400 mg per day

04/15: 58.1% PCR

08/15: 1.6% PCR, 0% FiSH

11/15: 0.6% PCR

02/16: 0.4% PCR

05/16: 0.1% PCR

09/16: 0.3% PCR, Began Gleevec 600 mg per day

12/16: 0.1% PCR

03/17: 0.2% PCR, Began Tasigna 600 mg per day

07/17: 0.08% PCR


#7 Melanie

Melanie

    Advanced Member

  • Members
  • PipPipPip
  • 219 posts
  • LocationArizona

Posted 06 February 2015 - 12:42 PM

Hi alc999, just had to pipe in...I live in Tucson. What Dr are you going to see at UMC? I know a lot of them in the area and your original onc who doesn't want to do a BMB is off standard protocol. Glad you've decided to look elsewhere. If you need anything or just want to chat, I'm here locally for you. Best to you! Melanie
Dx - 05/2011; PCR: 15.04; Fish: 87% Slow responder due to pancytopenia. Current - Bosulif - Nov: 2012, Mar 2016 lowered to 300 mg. 07/16 back to 400 mg. Clinical trial drug, Promacta, Feb 2013, for low Platelets.
CyCR - Aug 2014, Positive for 1 chromosome Sep 2015. PCR: 12.77 in Oct, 2012 to 0.04 (MDA) in Mar, 2016. 4/2016 - 0.126 (Local lab (IS); 05/2016 - 0.195 (local); 6/2016 - 0.07 (MDA); 7/2016 - 0.03 (local) 9/13/2016 - 0.16 (MDA); 9/26/2016 - 0.31 (MDA); 11/2016 - 0.012 (local); 01/2017 - 0.24 (MDA); 04/2017 - 0.09 (MDA); Cytogenetics show der(1:7)(q10;p10)7 chromosome mutation. Repeat of Sep 2015. PCR - 6/2017- 0.035 (local); 10/2017- 0.02 (MDA)

#8 alc999

alc999

    Advanced Member

  • Members
  • PipPipPip
  • 37 posts

Posted 06 February 2015 - 12:59 PM

Melanie - I have an appointment to see Dr Krishnadasan at the UA Cancer Center. He was recommended to me by a friend who's a doctor at UMC. But I'd love other recommendations if you have them! I was just diagnosed in the past week, and any help navigating CML resources in Tucson would be great. It's nice to hear that there's someone local on here!


01/15: Diagnosed, 195% PCR, 100% FiSH, Began Gleevec 400 mg per day

04/15: 58.1% PCR

08/15: 1.6% PCR, 0% FiSH

11/15: 0.6% PCR

02/16: 0.4% PCR

05/16: 0.1% PCR

09/16: 0.3% PCR, Began Gleevec 600 mg per day

12/16: 0.1% PCR

03/17: 0.2% PCR, Began Tasigna 600 mg per day

07/17: 0.08% PCR





1 user(s) are reading this topic

0 members, 1 guests, 0 anonymous users