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FISH vs Karyotyping


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#1 Tedsey

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Posted 10 January 2011 - 10:53 AM

Maybe some of you remember that I have never had a FISH done.  Anyway, my last BMB determined that I was in a CCyR (hurrah!).  However, this was determined by karyotyping done on 20 cells.  I assume there is some sort of mathematical formula that takes into account the average amount of blood cells in a human body.  So, 20 cells is an estimate (and taking the sensitivity limits of the test into consideration).  Since a FISH can look at a larger sample of cells (200-500?), is a FISH more accurate?  Just want to make sure I am not putting all my hopes and dreams on 20 normal cells (well, at least I have some--which means there are some non-leukemic stem cells at work).

Teds



#2 Trey

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Posted 10 January 2011 - 11:34 AM

The BMB is an accurate enough representation because it looks at the more rare progenitor cells that are in the actual state of dividing (reproducing) and are at the metaphase point where the chromosomes are at optimal visiblility.  Is 500 out of many billions better than 20 out of many billions?  It is like playing Lotto and buying several tickets and thinking your odds are greatly increased.  They are increased, but not enough to make a difference.

http://en.wikipedia.org/wiki/Metaphase

The FISH looks at the cells in a different way, looking for something specific, such as a specific translocation or a specific gene mutation.  The BMB looks at everything in the chromosomes (although sometimes with less clarity).  But any missed testing from a year ago is ancient history and has nothing to do with what your current tests show.

The zero BMB cytogenetics is a very good indicator of your status.  You are doing better and better as time goes on.  Your blood "quality" regarding increased numbers of good cells is improving.  You are making good progress.  You should be very encouraged.



#3 reedgirl

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Posted 10 January 2011 - 12:25 PM

Teds,

  I am encouraged by your great response so far. With everything you have gone through, I read this posting and what a sigh of relief! You are an encouragement to others to hang in there and keep fighting and pushing through, that great results can still be acquired!  Congrats on reaching CCyR, I pray you keep moving forward with even better results to come!!!


Audrey



#4 CallMeLucky

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Posted 10 January 2011 - 01:36 PM

Me's thinks someone is getting a little uncomfortable with the glass half full !

Take your wins when you get them Teds, you've had enough losses.  No point in not enjoying what you have achieved because tomorrow things may change.  You don't know what tomorrow if going to bring regardless of what today has shown you - be happy, you deserve it.  Your test results are clear, enjoy it, revel in it.  I know how you feel, because I often feel the same way, we're afraid to be happy because we think the rug will get pulled out from under us and it will be that much more painful.  We know the truth by now, regardless if we let our hopes get up or not, we will be sufficiently disappointed when something wrong in our lives.  For now, things look good, ride that wave, it would be a shame to look back 20 years from now and think "gee, I spent all that time worrying when I could have been happy".  I've wasted enough years in my life with that kind of thinking.  It's time to let myself enjoy the things that are good and I'll deal with the bad when they come, no point worrying about them now, not like my worrying will change the outcome.  My advice is that you do the same.

All the best


Date  -  Lab  -  Scale  -  Drug  -  Dosage MG  - PCR
2010/Jul -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 1.2%
2010/Oct -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.25%
2010/Dec -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.367%
2011/Mar -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.0081%
2011/Jun -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0%
2011/Sep -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.00084%
2011/Dec -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0%
2012/Mar -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0.004%
2012/Jun -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0%
2012/Sep -  MSKCC  -  Non-IS  -  Gleevec  - 400 - 0%
2012/Dec -  MSKCC  -  Non-IS  -  Sprycel  - 100 - 0%
2013/Jan -  Quest  -  IS  -  Sprycel  -  50-60-70  - 0%
2013/Mar -  Quest  -  IS  -  Sprycel  -  60-70  - 0%
2013/Apr -  CUMC  -  Non-IS  -  Sprycel  - 50 - 0.036%
2013/May -  CUMC  -  Non-IS  -  Sprycel  - 50 - 0.046%
2013/Jun -  Genoptix  -  IS  -  Sprycel  - 50 - 0.0239%
2013/Jul -  Genoptix  -  IS  -  Sprycel  - 70 - 0.0192%
2013/Jul -  Genoptix  -  IS  -  Sprycel  - 70 - 0.0034%
2013/Oct -  Genoptix  -  IS  -  Sprycel  - 70 - 0.0054%
2014/Jan -  Genoptix  -  IS  -  Sprycel  - 70 - 0.0093%
2014/Mar -  Genoptix  -  IS  -  Sprycel  - 100 - 0.013%
2014/Apr -  Genoptix  -  IS  -  Sprycel  - 100 - 0.0048%
2014/Jul -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2014/Nov -  Genoptix  -  IS  -  Sprycel  - 100 - 0.047%
2014/Dec -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2015/Mar -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2015/Jun -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2015/Sep -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2015/Dec -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2016/Mar -  Genoptix  -  IS  -  Sprycel  - 100 - 0.0228%
2016/Jun -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2016/Sep -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2016/Dec -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2017/Mar -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2017/Jun -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2017/Sep -  Genoptix  -  IS  -  Sprycel  - 100 - 0%
2017/Dec - Genoptix  -  IS  -  Sprycel  -  100 - 0%
 

 


#5 PhilB

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Posted 10 January 2011 - 08:50 PM

Hi Tedsey,

A FISH is indeed potentially more accurate - with population sizes this big the only thing that matters in determining sensitivityis the sample size, not the population size so it doesn't matter that the BMB work is looking at cells one level up.  The important thing here though is that CCyR has historically been DEFINED based on the 20 cell test and so all the statistics on what it means for prognosis are based on that test - not on the more sensitive FISH.  And the numbers show that if you can get to CCyR defined in this way and sustain it then you are in a very good place indeed.

All the best

Phil



#6 Tedsey

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Posted 11 January 2011 - 05:32 PM

I guess I also needed a taste of my own medicine, (Phil wrote about this once).  So complex is the human condition, (well, maybe not so much on paper or by observation, but definitely so by living the life).  Presently, I have been flirting with feeling comfortable since dx a year ago (not always hyper alert and anxious).  Also meaning, I have been allowing myself to live my life as I used to and push the fear of CML off to the side for longer periods of time (at least while awake--I tend to suffer from nightmares since dx).  It feels like I am sneaky when I do this and it scares me.  I am so used to living in the castle of doom.  I wonder if this can be compared a little to the Stockholm Syndrome?  (But instead I hold myself hostage--empathizing with myself--now that is a new concept!).   So, there are now minutes that I venture out and about and feel free (somewhat).  But I have a way to go before I don't feel I need to run back there for safety.  Wish the castle would explode.  Nevertheless, I totally get that it is OK to be happy with CCyR and have hope to reach old age.  Maybe, even to expect it.  Why not?  Dwelling on the alternative does make me miss the happiness I could have now.  Thanks Luck for pointing that out.  Thanks for throwing it back at me.  And thanks for adding that I will indeed look back (because I will be older tomorrow, nonetheless).  I need to hear it as much as I need to justify it by writing it.  Thanks to all of you for the info. on the FISH and BMB cytogenics.  I had no idea the current thought about CCyR, (and longevity), was based on CCyR determined by karyotyping.

Long life to all of us,

Tedsey 



#7 Marnie

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Posted 11 January 2011 - 07:27 PM

Tedsey. . . .get a motorcycle.  It cures everything!!



#8 Tedsey

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Posted 12 January 2011 - 01:41 PM

If they would invent an electric one, I am all over it!    



#9 PhilB

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Posted 12 January 2011 - 02:07 PM

http://www.zeromotorcycles.com/



#10 jwbwater

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Posted 12 January 2011 - 05:23 PM

http://www.brammo.com/



#11 Marnie

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Posted 12 January 2011 - 10:30 PM

Yea, Tedsey!!!  Let me know when you buy your new bike!!  We demoed an electric one at the National BMW rally.  Have to say. . .not as impressed as we'd hoped.  But you will look great on it!!

Finally got thru all of the red tape of new med. . .Sprycel will be coming on Friday.  Today is my first pill-less day.  Looking forward to 4 days without meds.  REally looking forward to my next PCR test!

Gotta get some work done. .. long day.  Contract negotiations is already starting up, so was downtown at the CEA building boning up on all of the political crap that will interfere with negotiations this year.  Finally got home after 8:00.   Now I need to bake a dessert for my husband's potluck at work tomorrow.  Then. . .get tomorrow's lessons plans prepped.  Sheesh!  The merry-go-round never stops!



#12 Tedsey

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Posted 13 January 2011 - 01:03 PM

Now guys, if I could just come up with an extra $10,000 U.S. dollars!  Guess I should have thought things through before I decided to have kids.  Afraid the motorcycle money is heading to their college funds right now.  Will have to hope that my kids end up rich and buy their mama a fun retirement gift.

Marnie,

Enjoy the TKI-free time.  Good luck with the Sprycel.  Please post how you are doing.  I so do not envy you going through the new contract negotiations.  I remember those days...  I so understand.  Try to get some rest!

Teds






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