4 replies to this topic

[sdl722]

I've been seeing Dr Kantarjian at MD Anderson since my diagnosis in mid-April.  In looking at my results online, it looks like I had a PCR test done on April 18th and then a month later on May 23rd (after being on Tasigna for 4 weeks).  A lot of people on here talk about specific percentages and numbers, but both times the results have just said the percentage is greater than 100 (see below).

REAL TIME BCR INTERP PB                          
BCR-ABL qRT-PCR:

A b2a2 BCR-ABL fusion transcript coding for the 210kDa BCR-ABL protein is
detected by real-time PCR.

The percentage of BCR-ABL to ABL transcripts is greater than 100.

COMMENT: Quantitative real-time PCR analysis performed on RNA from this
sample for the BCR-ABL fusion transcript resulting from the t(9;22) in
leukemia. BCR-ABL and ABL transcript levels are detected simultaneously
and quantitative results expressed as the ratio of BCR-ABL to ABL levels.
This ratio may vary up to one-log because of methodological reasons.  As
of 8/2/07, the assay has shifted to a new platform.

Why would the report not be more specific?  Before I saw some of these  results I asked Dr. Kantarjian about PCR and he says that is generally  done a bit later.  I have my 3 month checkup next week where I get another BMA and see the doctor, so I can ask him then, but wanted to hear if any of you had thoughts on this.

Thanks,

Stephen

[Trey]

If it were me, I would want to have a PCR re-done and also have a FISH done to check on the PCR results.

If the PCR is truly remaining over 100%, then you will want to discuss whether you should have a Kinase Mutation Test and whether you should switch to Sprycel soon if there is no progress in the very near future.

[sdl722]

Thanks Trey.  My FISH in April was 99.5% (BM) and then in May it was down to 66% (PB).  Again, this was only having been on Tasigna for 4 weeks.  I'll be having all of that done again on July 28th, so hopefully I will get some more clarity on the PCR once I have those results.

[sdl722]

Ok my 3 month pcr came back and it was down to 8.54 from over 100 previously.  I don't have the fish yet which my dr said is more important at this point.  I asked the nurse if they calculated log reductions and she said yes but that dr kantarjian would go over that with me at my next visit in oct. To me it seems like at least a 1 log reduction. I figured I would wait until I get my fish and then give the doctor a call.  Stephen

[Trey]

Your personal log reduction is easily over 1 log.  From what Michael of this group says, the MD Anderson log scale is a bit odd:

http://community.lls...art=0&tstart=30

From what I can understand, the MDA conversion factor could be approx .35 x MDA PCR = IS PCR.  If that is trye (and I don't know for certain) your IS PCR would be about 2.9 which would put you closer to 2 log reduction than 1 log.  Whatever the values, you have made some good progress.