6 replies to this topic

[JoshLee]

So I got a second opinion at Sylvester Cancer Center in Miami with Dr. Mark Goodman, mostly because my work paid for it. Anyways, I got the results back and I am having trouble interpreting them. In a nut shell it says " Minor P190" not detected.....BCR-ABL p210 ratio= 0.02666. International Scale Percentage= 3.2836%. I know I cannot compare labs, but do these numbers tell me anything about the level of disease in my body? Is it low and what is the difference between International Scale and the "other" scale? Where do you have to be on the international scale to be considered CCR? My main lab doesn't use international scale and as of 6 months I was at a 1.1 log reduction. Can I calculate any further response with the new PCR report? Also, is 3.2% IS acceptable for 7 months on treatment? It seems a little high to me from the other research I've done. Thanks, Josh

[JoshLee]

Also, at DX I wasn't using International Scale and I started at 1.1 but then had a 1.1 log reduction at 6 months. Is there a way to tell if 3.2836% IS a decrease or an increase from the other scale? So confused about this crap!

[Trey]

The first part says that you have the "regular" form of CML which is P210 (b2a2 or b3a2), and that you do not show the P190 (e1a2) type  So you have either b2a2 or b3a2 type of breakpoint, not e1a2.

http://community.lls.org/docs/DOC-1272

Your .02666 ratio would be 2.666% before conversion to International Scale (IS).  Thise number might relate better to previous results.  Then the lab has used a conversion factor to report the result in IS scale.  The result in IS scale is 3.2836%.

Log reduction equivalents for IS are:

100% = zero log reduction

10%   = 1 log reduction

1%     = 2 log reduction

.1%    = 3 log reduction

So you are approaching a 2 log reduction, which is also roughly equivalent to CCyR.  Re-read this about response rates and where you might fit in:

http://community.lls.org/thread/11781

[JoshLee]

So if I had a 1.1 log reduction at 5.5 months, have I made some progress since then? I know I might be splitting hairs, but it's worth it to me to know...I guess. I feel like looking at the stats I am responding pretty okay. I am by no means "speedy", but the drug is working okay for me. I feel like I keep getting tested 3 weeks ahead of schedule. My 9 month since starting February 5th, 2011 is probably going to be done in early October....at 8 months because I travel between work and my Onc. Does this matter? How much of an effort is it for the medicine to drop me from 2.6% to 1%? It's confusing as to what is a big drop and what isn't. I know this all depends on how strong the CML cells are that are higher up the totem pole. I was 10% Cytogenetics on July 18th....Do you think it would be less or the same at this point? Thanks for your help, Trey.

[JoshLee]

I had a friend help me figure out my log reduction based on the international scale with 10% being a 1 log reduction and 1% being a 2 log reduction. I was at 3.2% on the IS so we figured through some calculations that I was sitting roughly around a 1.5 log reduction. Which is better than the 1.1 log reduction I was sitting at a month and a half earlier. Can log reduction be translated into FISH percentage? Thanks for your help everyone. -Josh

[Trey]

A zero Fish is roughly equivalent to a 2 log reduction PCR.  Both are considered CCyR.

[cousineg]

Another link about PCR test : http://www.cmleukemi...n-reaction.html