3 replies to this topic

[JJR]

Hello,

I would like to hear what others who have experienced this have heard from their doctors/experts.  My BCR-ABL went down dramatically in the last 3 months, the potential best news I have received to date, from 2.55 to .0489 yet my FISH PH+ detectable went from 22% to 26%. I believe my results have been coming from the same lab.  Dr. Shah, during my 2nd opinion appt. #2, stated that something to the effect that FISH results do not always correlate with BCR-ABL.  It seems weird that PH+ detectable would not have taken a serious hit with this result. What have others heard?

Thanks for any responses.

JJR

[Trey]

That is a fairly large "non-correlation" of PCR to FISH.  There are others with divergent results, but it is not clear why this happens.

Were these done on peripheral blood or marrow aspirate?

[JJR]

Trey,

I believe it was peripheral but I will check today b/c I had both a BMB and peripheral genetic testing done within a few days of each other.  I find it strange as well, makes me think that the PH+ result includes false positives, per NCCN, there is a 1-10% false positive rate with FISH.  I also don't know however, how many cells were looked at with the particular FISH I had, so maybe this is a factor in the false positive rate.  I hate having to play statistician and molecular biologist to figure out my own results, I am ill-equiped at both.  Tell me, is 2.55 to .0489 a roughly 2 log reduction?

Thanks,

JJR

[Trey]

The PCRs are close to a 2 log reduction.  A 2 log reduction is roughly considered a CCyR and will normally yield a zero FISH.  But either the PCR could be wrong or the FISH wrong or both.  Yes, I know, it sucks that we cannot rely on these tests to the degree we want to.  There are numerous opportunities to affect results in the testing processes, blood draw, shipping, time, lab errors, equipment issues, inherent errors, etc.