15 replies to this topic

[cpsn0000]

Had my second appt today with my new hematologist and my BMB went very well. No pain after the procedure and only expects a little sorness for a couple of days. By far, a much better expierenece already with this doctor. Also starting Tasigna tomorrow on a reduced dose of 150mg 2x a day for 7 days and as long as my EKG is still perfect, I will go to my normal dose of 300mg 2x a day after that. My other onc never did a PCR or FISH during diagnosis and only my BMB was done. My PCR from my first test with my new doctor was .008047. Can anyone tell me how bad this is? I started taking Gleevec on 10-6-10 and had 1% lukemic cells from the BMB report. How will I know I am doing with with the PCR testing in regards to the log reductions? I hope this helps my blood counts stabalize with Tasigna where Gleevec kept dropping my WBC and PLT counts.

[cpsn0000]

As explained on this discussion board, nice to see my new doctor easing me into my regular dose of Tasinga to help my body adjust and minimize any side effects or low counts. I cross my fingers this works because I felt great on Gleevec but had problems with my blood counts after 3 months of being on it. My doctor said if any problems arise with WBC here, will give me those lovely growth factor white blood shots to help my body adjust.

[Trey]

You said your original BMB was only 1%, but the lowest BMB number is 5% since only 20 cells are examined.  So the 1% was likely a FISH test done at the same time.*  The FISH is often reported on the BMB report if both are done at the same time.  Your PCR ais .008.  But you said previously your WBC at diagnosis was over 200K.  It would be unusual to start out with a low BMB/FISH and also 200K WBC.  Just wondering about the inconsistencies of test results.  But it appears you are doing well.

*[EDIT: Note that later the 1% was identified as the blast count.]

Message was edited by: Trey

[PhilB]

As Trey says, those initial test numbers do look inconsistent.  I wonder if the 1% might have been the blasts number?

[cpsn0000]

I am really not sure. My doctor is excellent but didn't have a chance to get the info from him. I got the information from his assistant who really doesn't know her ass from a hole in the wall. I will update again when I have the information provided to me fully explained. I remember my old onc saying that had no cells in the accelerated or blastic phase which was good, if that makes sense.

[cpsn0000]

PCR and Fish Test was done on 12-23-10. Shows BCR/ABL Ratio .008047.....Is this the PCR or FISH? This is something I need to make sure is better explained to me on my next appt.

[Marnie]

That is the PCR, and that is the number that you will be watching to monitor your progress.  Wish my numbers were as good as yours are!!

[PhilB]

I wonder if that is indeed a 'ratio' rather than a percentage.  Assuming the lab was on international scale then 0.008% after 2.5 months on G would be a fantastic result.  If, on the other hand, it's a straight ratio then the percentage would be 0.8% which is still jolly nice at this stage of treatment.  Either way you're looking good at this stage.  At your next appointment I'd ask the onc what PCR figure is considered a Major Molecular Response (MMR) for that lab - that will give you a target figure to measure your progress towards.

Now for the really startling aspect of your post - you got your PCR results in only 7 days!  And over Xmas!  I think that may be a record.

[cpsn0000]

I appreciate the feedback. I will ask those questions so I can understand where I need to be. I met with the PA and my doctor and the PA didn't realize my PCR had come back already and gave me my results when I was leaving. 

[CallMeLucky]

I get the sense the PCR comes back fairly quickly, perhaps an automated process.  I got my last PCR back within a few days, still waiting on the FISH, which makes no sense, I am starting to think someone lost something.

Your PCR numbers look really good.

[Trey]

A comment for everyone: the only way to get help with test results is to get copies of all test reports.  Without them, you are guessing and we are trying to respond to those guesses, which is a formula for bad information.

[cpsn0000]

Trey,

What should I be asking for? I got a copy of my hospital report and no PCR or FISH test was done with the exception of the BMB that had on their 1% of cells were positive for CML. On my blood work it showed BCR/ABL Ratio being .008047 which was done for the 1st time on 12/23/10..is this the PCR? I wont get a copy of BMB for at least a week or so.

So I don't create any more problems, please explain exactly what reports I should be asking for and can you break down the information I should be getting in those reports so I am better prepared for my next visit come this Friday? I get my weekly blood work sheets which I understand and once I get a copy of my new BMB, I will be better prepared to get all this information out to the group.

Thanks!!

[Trey]

Every time a test is done and results are given verbally, ask for a copy.  PCR, FISH, BMB, CBC, CMP, whatever.  Start by asking what tests have been done to date, and see if you have copies of each.

For now, if you have the BMB report, type out the exact sentence with the "1%" in it and any pertinent surrounding sentences.  Also the sentence from the report with the ".008047" in it, which would indeed be a PCR.  That would help us help you figure these out.

[cpsn0000]

FISH test was done in hospital but is hard to understand results back on 10-7-10. The statement for 1% leukemia is "Bone Marrow: CD34 Positive myleoblasts are not increased, 1% of total cells.. This finding is consistent with chronic phase of CML."

"FISH test positive for the BCR/ABL rearrangement"

Also, "WBC morpoholgy, increased immature granulocytes including promylocytes, myelocytes, and metamylocytes are seen. Approx 2% blasts and 2% basophils are seen. No Auer rods are identified."

These two statements came from hospital report. I get my CBC's which is were they put my PCR result on.

on CBC report from 12-23-10 "BCR/ABL Ratio .008047" Says submitted BCR/ABL translocation quant RT-PCR BCR/ABL. Translocation quant RT-PCR which means this should be my PCR test as my PA sayed to me.

Is this any better? I was wrong about no FISH test was done in hospital....New doctor will check FISH and PCR monthly and recheck my bone marrow in 3 months for CCR. I should have results back from BMB hopefully in a week or so.

Thanks as always for your input...

[Trey]

So the 1% is the blast count (myeloid type) with total blasts at 2% (myeloid and lymphoid), so this is not a BMB, PCR, or FISH.  But the blast count is low, which is good.

The report that says "FISH test positive for the BCR/ABL rearrangement" should also have a line in the report that provides the number.  It often says "nuc ish" and ends with X / 200 or something like that (where "X" is the number of leukemic cells found).

Your PCR "BCR/ABL Ratio .008047" may not be a percentage, which is how they are supposed to be reported.  What lab is listed on the PCR report?

[cousineg]

Hi,

   You can obtain some information on PCR result at http://www.cmleukemi...n-reaction.html

With best regards,

                 

                          Gilles