FISH results

[Guest guest]

Can someone make some sense of this for me? My heme-onc

told me that my FISH results were " normal " . I wasn't sure

what that meant so I tried to ask about specifics. The

response I got was " We only check for the bad things and

your results were normal. " Is this standard protocol? What

should I assume to be " normal " FISH results and what does

this mean? Thanks for your help.

Jay Gee

W & W

June 28, 2011

[Guest guest]

Hello ita,

CLL Topics covers this well:

http://clltopics.org/Alert/direct_display_alert.php?reqnum=136

" The generic CLL FISH panel therefore often looks for only

these four chromosomal defects: 13q, 12 trisomy, 11q and

17p. If none of the above four defects are detected, the lab

reports this as a “normal” karyotype, but as you can see

that is a not an accurate description of the actual state of

affairs. It just means the patient in question has one or

more chromosomal defects that we do not know about and have

not tested for. A more accurate description of a CLL patient

who does not have any of these 4 defects would be “unknown

chromosomal defect or defects”. We lump all the CLL patients

who have “unknown” but very real defect(s) into one group,

and call them “normal”. Since your have the big “C”, it goes

with the territory that your CLL cells have one or more

chromosomal defects. Whether we know what the defects are,

or whether we know how to test for them, or bother to test

for them, those are questions that your CLL cells do not

care about. "

" This explains why folks with “normal” karyotype have worse

prognosis than those with 13q deletion. Since “normal”

actually means a bunch of defects we know nothing about, the

empirically observed poorer prognosis of this group

represents the average prognosis of all these unknown

defects. “Normal” karyotype is a catch-all category at this

point. Since we have no way of judging the unknown, a

patient with a relatively less dangerous unknown chromosomal

defect can do a lot better than another patient who has a

more dangerous and equally unknown defect. That is the luck

of the draw. "

I also had a " Normal " fish. I am Stage 1, 2 years past

diagnosis, untreated and doing well.

Kay

[Guest guest]

Hi Jay Gee,

I am a fairly new CLL patient on W & W too but I insist on

having a copy of every single test and report from the

doctor and hospital and lab. I keep a copy on my computer

and on a disk so I can email/fax or send all results if I

need a consultation. I also keep a chart of all my lab

results evey time I have a blood test.

You have a right to your results and your values. And it's

good to know exactly what tests were actually run.

Good luck to you as you increase your knowledge and manage

your illness.

Try http://updates.clltopics.org/ Great amount of info from a

wonderful expert and mentor.

Q

Mod's note from :

Download the CLL Booklet (left column) from the CIG website:

http://www.cllinfogroup.org/ (home page of this group)

Jay Gee wrote:

/message/16012

[Guest guest]

This is a poor choice of terms. We do refer to not having

one of the interphase FISH abnormalities as being normal,

but we only look for four specific abnormalities. (Hence,

only see what we fish for...) Many other abnormalities might

be present.

Earlier work found that the following four abnormalities

were recurrent in CLL and had prognostic implications (with

possible important genes lost in parentheses):

del 13q14 (microRNA)

trisomy 12

del 11q22 (ATM gene)

del 17p (p53)

If one of the above is not seen, then the term normal is

used. Some may have trisomy 21 (Down's syndrome) and will

have a normal iFISH panel. Thus, normal is more accurately

termed, " none of the above " .

At Cornell we also FISH for chromosome 6q abnormalities, but

the above panel is the standard panel.

Rick Furman, MD

Jay Gee wrote:

/message/16012

[Guest guest]

Dr. Furman,

It's always tricky when things are defined in the negative,

especially several negatives! Do I understand you correctly

--are you saying that " normal " used to be defined as missing

as few as one or more of the abnormalities but that unlike

back then, " normal " now means not having any of the 4

abnormalities? "

[Guest guest]

Normal for iFISH just means not having a del 13q14,

del 11q22, trisomy 12, or del 17p

Frances Friedman wrote:

> It's always tricky when things are defined in the negative,

> especially several negatives! Do I understand you correctly

> --are you saying that " normal " used to be defined as missing

> as few as one or more of the abnormalities but that unlike

> back then, " normal " now means not having any of the 4

> abnormalities? "

[Guest guest]

I spoke with my heme onc who told me that my iFISH was

" normal " and she followed up with a letter that read " FISH

analysis did not show any evidence of P53 or P17 deletion.

This is clearly reassuring. " So am I to assume the other 3

abnormalities were not found? Not sure now where does P53

come in as a part of FISH and/or is it related to P17

deletion? Please pardon my ignorance. This gets to be a

little confusing.

Jay Gee

Dr. Furman wrote:

> Normal for iFISH just means not having a del 13q14,

> del 11q22, trisomy 12, or del 17p

[Guest guest]

The gene thought to be missing in 17p deletions is p53.

Regarding the other abnormalities, it would depend upon what

they tested for.

Rick Furman

Jay Gee wrote:

I spoke with my heme onc who told me that my iFISH was

" normal " and she followed up with a letter that read " FISH

analysis did not show any evidence of P53 or P17 deletion.

This is clearly reassuring. " So am I to assume the other 3

abnormalities were not found? Not sure now where does P53

come in as a part of FISH and/or is it related to P17

deletion?

Dr. Furman wrote:

> Normal for iFISH just means not having a del 13q14,

> del 11q22, trisomy 12, or del 17p