Re: Major Molecular Response

August 1, 2007

Hi Mark,

BCR/ABL RATIO 0.00005

This is certainly a good result (0.005%) and I believe it's well below MMR.

My lab, Stanford hospital (as I think MD ), gives the result as this

ratio. In simple terms it's the number of cells with the cml gene (with the

translocation) divided by the total number of cells in the blood sample, but

in fact it's more complicated than that (it's the ratio of the number of

copies after making the cells proliferate a number of cycles) and it changes

from lab to lab, even with the ones that are converging towards an emerging

international standard.

MMR is defined as a 1000 fold reduction (3 log) of this ratio from the value

at dx (often an average value for the lab). Depending on the labs (the ones

that use this ratio) MMR is around 0.001 and 0.0005.

To really tell what is the reduction of your cml cells something is missing

in this report : the ratio at dx, or the average ratio at dx (over previous

patients). On my test this baseline ratio is 1.04, but it has no reason to

be the same at your lab. Also the limit of detection at 1 over 1000 cell is

weird, it should be 1 to 100000 or better.

Anyway it's a darn good result at one year, I have still about 50 times that

(dx in march 05) and I am not so worried, it is still going down, slowly

getting to MMR, and I am staying at 400mg to keep enjoying scuba, unless it

goes up.

Cheers,

Marcos.

--

Marcos Perreau Guimaraes

Suppes Brain Lab

Ventura Hall - CSLI

Stanford University

220 Panama street

Stanford CA 94305-4101

650 614 2305

650 630 5015 (cell)

marcospg@...

montereyunderwater@...

www.stanford.edu/~marcospg/

On 7/31/07, markostapiak <no_reply > wrote:

>

> Hello all,

>

> I'm a 29 year old white male who was diagnosed with CML in June 2006.

> My WBC at the time was 335,000. That's down to normal and all my other

> numbers are stable.

>

> I was started on 400mg of Gleevec in July 2006 and stepped up to 600mg

> in August 2006, which is my current dosage.

>

> Here's a copy of my latest test:

>

> bcr/abl,t(9;22) Translocation Quantitative Assay by RT-PCR

>

> BCR/ABL SOURCE NOT SPEC

>

> BCR/ABL QUANTITATIVE 1 Q POS

>

> Positive: There is evidence of the bcr/abl fusion

>

> trancript by RT-PCR analysis.

>

> This result has been reviewed and approved by

>

> D. B., M.D. [used initials to protect doc's identity]

>

> Results are reported as a ratio of bcr/abl transcripts to

>

> G6PDH transcripts.The limit of detection for this assay

>

> is 1 in 1,000 cells.

>

> BCR/ABL RATIO 0.00005

>

> BCR/ABL PREVIOUS SOURCE NOT APPL

>

> BCR/ABL PREVIOUS DRAW DT/TIME NOT APPL

>

> BCR/ABL PREVIOUS QUANT 1 NOT APPL

>

> BCR/ABL PREVIOUS QUANT RATIO NOT APPL

>

> So, my doctor said that this means a Major Molecular Response. What

> does that really mean? I know that's pretty good, but is that as good

> as it can get?

>

> Put it in laymans terms, please. I appreciate the help.

>

> Sincerely,

> Mark

>

August 1, 2007

Hi Mark and Marcos,

Anytime a number is that low it's a good thing but I'm not sure how

significant it is if the PCR's sensitivity was only 1 in 1,000.

By definition, the famous 3 log reduction that we're all aiming for

(which is how they define a major molecular response) , is a

reduction in transcripts by 1000 fold. Now if someone is still

positive on a test that only has a sensitivity of 1,000, would that

not mean that their reduction is less than a 1000?

As I've stated in previous posts, math is hardly my strong suit but I

do know that the experts have said that PCR's with sensitivities of

less than 1 in 100,000 are unreliable and give little information.

Mark, I would suggest that you ask if you can send your samples to

another lab where they do more sensitive testing and this way you'll

know exactly where you stand.

Tracey

> >

> > Hello all,

> >

> > I'm a 29 year old white male who was diagnosed with CML in June

2006.

> > My WBC at the time was 335,000. That's down to normal and all my

other

> > numbers are stable.

> >

> > I was started on 400mg of Gleevec in July 2006 and stepped up to

600mg

> > in August 2006, which is my current dosage.

> >

> > Here's a copy of my latest test:

> >

> > bcr/abl,t(9;22) Translocation Quantitative Assay by RT-PCR

> >

> > BCR/ABL SOURCE NOT SPEC

> >

> > BCR/ABL QUANTITATIVE 1 Q POS

> >

> > Positive: There is evidence of the bcr/abl fusion

> >

> > trancript by RT-PCR analysis.

> >

> > This result has been reviewed and approved by

> >

> > D. B., M.D. [used initials to protect doc's identity]

> >

> > Results are reported as a ratio of bcr/abl transcripts to

> >

> > G6PDH transcripts.The limit of detection for this assay

> >

> > is 1 in 1,000 cells.

> >

> > BCR/ABL RATIO 0.00005

> >

> > BCR/ABL PREVIOUS SOURCE NOT APPL

> >

> > BCR/ABL PREVIOUS DRAW DT/TIME NOT APPL

> >

> > BCR/ABL PREVIOUS QUANT 1 NOT APPL

> >

> > BCR/ABL PREVIOUS QUANT RATIO NOT APPL

> >

> > So, my doctor said that this means a Major Molecular Response.

What

> > does that really mean? I know that's pretty good, but is that as

good

> > as it can get?

> >

> > Put it in laymans terms, please. I appreciate the help.

> >

> > Sincerely,

> > Mark

> >

>

August 1, 2007

O!!! YIPPEEE!!!

Number 1086 in the Zero Club

Zavie

Marko, could you please send me your email address. I have some questions

and information for you.

In layman’s terms, a 3 log reduction is as good as it gets. There is

virtually no chance that you will relapse given this response. A very small

percentage of patients achieve PCRU, but it doesn’t change the long term

outcome.

Zavie

Zavie (age 69)

67 Shoreham Avenue

Ottawa, Canada, K2G 3X3

dxd AUG/99

INF OCT/99 to FEB/00, CHF

No meds FEB/00 to JAN/01

Gleevec since MAR/27/01 (400 mg)

CCR SEP/01. #102 in Zero Club

2.8 log reduction Sep/05

3.0 log reduction Jan/06

2.9 log reduction Feb/07

3.2 log reduction Jun/07

e-mail: zmiller@...

Tel: 613-726-1117

Fax: 309-296-0807

Cell: 613-202-0204

ID: zaviem

_____

From: [mailto: ] On Behalf Of

markostapiak

Sent: August 1, 2007 1:51 AM

Subject: [ ] Major Molecular Response

Hello all,

I'm a 29 year old white male who was diagnosed with CML in June 2006.

My WBC at the time was 335,000. That's down to normal and all my other

numbers are stable.

I was started on 400mg of Gleevec in July 2006 and stepped up to 600mg

in August 2006, which is my current dosage.

Here's a copy of my latest test:

bcr/abl,t(9;22) Translocation Quantitative Assay by RT-PCR

BCR/ABL SOURCE NOT SPEC

BCR/ABL QUANTITATIVE 1 Q POS

Positive: There is evidence of the bcr/abl fusion

trancript by RT-PCR analysis.

This result has been reviewed and approved by

D. B., M.D. [used initials to protect doc's identity]

Results are reported as a ratio of bcr/abl transcripts to

G6PDH transcripts.The limit of detection for this assay

is 1 in 1,000 cells.

BCR/ABL RATIO 0.00005

BCR/ABL PREVIOUS SOURCE NOT APPL

BCR/ABL PREVIOUS DRAW DT/TIME NOT APPL

BCR/ABL PREVIOUS QUANT 1 NOT APPL

BCR/ABL PREVIOUS QUANT RATIO NOT APPL

So, my doctor said that this means a Major Molecular Response. What

does that really mean? I know that's pretty good, but is that as good

as it can get?

Put it in laymans terms, please. I appreciate the help.

Sincerely,

Mark

August 1, 2007

Hi Tracey,

If I had to bet I d say the 1000 is wrong (typo ?), 1/0.00005 is 20000 so

the sensibility should be at least 1:20000. I find strange also that they

don't give the baseline and the log reduction, what is the standard

interpretation of this test. Though they give the house keeping gene (G6PDH)

what I don't have on my reports.

Marcos.

On 8/1/07, Tracey <traceyincanada@...> wrote:

>

> Hi Mark and Marcos,

>

> Anytime a number is that low it's a good thing but I'm not sure how

> significant it is if the PCR's sensitivity was only 1 in 1,000.

>

> By definition, the famous 3 log reduction that we're all aiming for

> (which is how they define a major molecular response) , is a

> reduction in transcripts by 1000 fold. Now if someone is still

> positive on a test that only has a sensitivity of 1,000, would that

> not mean that their reduction is less than a 1000?

>

> As I've stated in previous posts, math is hardly my strong suit but I

> do know that the experts have said that PCR's with sensitivities of

> less than 1 in 100,000 are unreliable and give little information.

>

> Mark, I would suggest that you ask if you can send your samples to

> another lab where they do more sensitive testing and this way you'll

> know exactly where you stand.

>

> Tracey

>

> > >

> > > Hello all,

> > >

> > > I'm a 29 year old white male who was diagnosed with CML in June

> 2006.

> > > My WBC at the time was 335,000. That's down to normal and all my

> other

> > > numbers are stable.

> > >

> > > I was started on 400mg of Gleevec in July 2006 and stepped up to

> 600mg

> > > in August 2006, which is my current dosage.

> > >

> > > Here's a copy of my latest test:

> > >

> > > bcr/abl,t(9;22) Translocation Quantitative Assay by RT-PCR

> > >

> > > BCR/ABL SOURCE NOT SPEC

> > >

> > > BCR/ABL QUANTITATIVE 1 Q POS

> > >

> > > Positive: There is evidence of the bcr/abl fusion

> > >

> > > trancript by RT-PCR analysis.

> > >

> > > This result has been reviewed and approved by

> > >

> > > D. B., M.D. [used initials to protect doc's identity]

> > >

> > > Results are reported as a ratio of bcr/abl transcripts to

> > >

> > > G6PDH transcripts.The limit of detection for this assay

> > >

> > > is 1 in 1,000 cells.

> > >

> > > BCR/ABL RATIO 0.00005

> > >

> > > BCR/ABL PREVIOUS SOURCE NOT APPL

> > >

> > > BCR/ABL PREVIOUS DRAW DT/TIME NOT APPL

> > >

> > > BCR/ABL PREVIOUS QUANT 1 NOT APPL

> > >

> > > BCR/ABL PREVIOUS QUANT RATIO NOT APPL

> > >

> > > So, my doctor said that this means a Major Molecular Response.

> What

> > > does that really mean? I know that's pretty good, but is that as

> good

> > > as it can get?

> > >

> > > Put it in laymans terms, please. I appreciate the help.

> > >

> > > Sincerely,

> > > Mark

> > >

> >

August 1, 2007

Hi Marcos,

I have heard in the past that some labs are only doing 1 in 1,000

PCR's but of course it is very possible that Mark made a typo when he

reported it. It seems to me that a PCR that's that low in

sensitivity is a waste of time and not much better than a FISH.

I have a few old PCR reports that mention the housekeeping gene. My

more recent ones don't mention it though and it makes me wonder which

gene they're using but then again, I don't think I really care

Being mathematically challenged the way I am, I'm just very grateful

that my lab says exactly what my log reduction is, this way I don't

have to figure anything out

Tracey

-- In , " Marcos Perreau Guimaraes "

<montereyunderwater@...> wrote:

>

> Hi Tracey,

> If I had to bet I d say the 1000 is wrong (typo ?), 1/0.00005 is

20000 so

> the sensibility should be at least 1:20000. I find strange also

that they

> don't give the baseline and the log reduction, what is the standard

> interpretation of this test. Though they give the house keeping

gene (G6PDH)

> what I don't have on my reports.

> Marcos.

>

> On 8/1/07, Tracey <traceyincanada@...> wrote:

> >

> > Hi Mark and Marcos,

> >

> > Anytime a number is that low it's a good thing but I'm not sure

how

> > significant it is if the PCR's sensitivity was only 1 in 1,000.

> >

> > By definition, the famous 3 log reduction that we're all aiming

for

> > (which is how they define a major molecular response) , is a

> > reduction in transcripts by 1000 fold. Now if someone is still

> > positive on a test that only has a sensitivity of 1,000, would

that

> > not mean that their reduction is less than a 1000?

> >

> > As I've stated in previous posts, math is hardly my strong suit

but I

> > do know that the experts have said that PCR's with sensitivities

of

> > less than 1 in 100,000 are unreliable and give little information.

> >

> > Mark, I would suggest that you ask if you can send your samples to

> > another lab where they do more sensitive testing and this way

you'll

> > know exactly where you stand.

> >

> > Tracey

> >

> > > >

> > > > Hello all,

> > > >

> > > > I'm a 29 year old white male who was diagnosed with CML in

June

> > 2006.

> > > > My WBC at the time was 335,000. That's down to normal and all

my

> > other

> > > > numbers are stable.

> > > >

> > > > I was started on 400mg of Gleevec in July 2006 and stepped up

to

> > 600mg

> > > > in August 2006, which is my current dosage.

> > > >

> > > > Here's a copy of my latest test:

> > > >

> > > > bcr/abl,t(9;22) Translocation Quantitative Assay by RT-PCR

> > > >

> > > > BCR/ABL SOURCE NOT SPEC

> > > >

> > > > BCR/ABL QUANTITATIVE 1 Q POS

> > > >

> > > > Positive: There is evidence of the bcr/abl fusion

> > > >

> > > > trancript by RT-PCR analysis.

> > > >

> > > > This result has been reviewed and approved by

> > > >

> > > > D. B., M.D. [used initials to protect doc's identity]

> > > >

> > > > Results are reported as a ratio of bcr/abl transcripts to

> > > >

> > > > G6PDH transcripts.The limit of detection for this assay

> > > >

> > > > is 1 in 1,000 cells.

> > > >

> > > > BCR/ABL RATIO 0.00005

> > > >

> > > > BCR/ABL PREVIOUS SOURCE NOT APPL

> > > >

> > > > BCR/ABL PREVIOUS DRAW DT/TIME NOT APPL

> > > >

> > > > BCR/ABL PREVIOUS QUANT 1 NOT APPL

> > > >

> > > > BCR/ABL PREVIOUS QUANT RATIO NOT APPL

> > > >

> > > > So, my doctor said that this means a Major Molecular Response.

> > What

> > > > does that really mean? I know that's pretty good, but is that

as

> > good

> > > > as it can get?

> > > >

> > > > Put it in laymans terms, please. I appreciate the help.

> > > >

> > > > Sincerely,

> > > > Mark

> > > >

> > >

August 2, 2007

Hi,

I'm so glad that folks have chimed in on this one. I double checked my

PCR results, and they report 1:1000 sensitivity ratio (sensitivity

ratio? Is that the correct terminology?). I'll have to ask my doctor.

When I go in for a check up in September, I'll ask him all the

questions that you've raised, as well as discuss the answers you've

offered, especially one mentioning that a 3log reduction means

" virtually no chance of relapse. " Truly?

This is pretty confusing stuff.

Sincerely,

Mark

> > > > >

> > > > > Hello all,

> > > > >

> > > > > I'm a 29 year old white male who was diagnosed with CML in

> June

> > > 2006.

> > > > > My WBC at the time was 335,000. That's down to normal and all

> my

> > > other

> > > > > numbers are stable.

> > > > >

> > > > > I was started on 400mg of Gleevec in July 2006 and stepped up

> to

> > > 600mg

> > > > > in August 2006, which is my current dosage.

> > > > >

> > > > > Here's a copy of my latest test:

> > > > >

> > > > > bcr/abl,t(9;22) Translocation Quantitative Assay by RT-PCR

> > > > >

> > > > > BCR/ABL SOURCE NOT SPEC

> > > > >

> > > > > BCR/ABL QUANTITATIVE 1 Q POS

> > > > >

> > > > > Positive: There is evidence of the bcr/abl fusion

> > > > >

> > > > > trancript by RT-PCR analysis.

> > > > >

> > > > > This result has been reviewed and approved by

> > > > >

> > > > > D. B., M.D. [used initials to protect doc's identity]

> > > > >

> > > > > Results are reported as a ratio of bcr/abl transcripts to

> > > > >

> > > > > G6PDH transcripts.The limit of detection for this assay

> > > > >

> > > > > is 1 in 1,000 cells.

> > > > >

> > > > > BCR/ABL RATIO 0.00005

> > > > >

> > > > > BCR/ABL PREVIOUS SOURCE NOT APPL

> > > > >

> > > > > BCR/ABL PREVIOUS DRAW DT/TIME NOT APPL

> > > > >

> > > > > BCR/ABL PREVIOUS QUANT 1 NOT APPL

> > > > >

> > > > > BCR/ABL PREVIOUS QUANT RATIO NOT APPL

> > > > >

> > > > > So, my doctor said that this means a Major Molecular Response.

> > > What

> > > > > does that really mean? I know that's pretty good, but is that

> as

> > > good

> > > > > as it can get?

> > > > >

> > > > > Put it in laymans terms, please. I appreciate the help.

> > > > >

> > > > > Sincerely,

> > > > > Mark

> > > > >

> > > >

August 2, 2007

Hi Mark,

The followup of the IRIS patients (from initial clinical trials to last

year) shows that 100% of these people that reach MMR in the 1st 18 months of

treatment have no disease progression in 5 years (going from chronic phase

to more advanced accelerated or blast phases). For the people that reach CCR

at 12 month 97% have no disease progression in 5 years. The other very good

thing is the available data show the odds of having cml progressing decrease

with time : longer you stay in remission, better are the chances of staying

in remission. Here's a link to the IRIS 5 year update slides from Novartis :

http://www.glivec.com/pdfs/2-IRIS-5YearUpdate.pdf

For your PCR test you should ask your doctor, I agree with Tracey, 1:1000 is

not good enough.

Marcos.

On 8/2/07, markostapiak <no_reply > wrote:

>

> Hi,

>

> I'm so glad that folks have chimed in on this one. I double checked my

> PCR results, and they report 1:1000 sensitivity ratio (sensitivity

> ratio? Is that the correct terminology?). I'll have to ask my doctor.

>

> When I go in for a check up in September, I'll ask him all the

> questions that you've raised, as well as discuss the answers you've

> offered, especially one mentioning that a 3log reduction means

> " virtually no chance of relapse. " Truly?

>

> This is pretty confusing stuff.

>

> Sincerely,

> Mark

>

> > > > > >

> > > > > > Hello all,

> > > > > >

> > > > > > I'm a 29 year old white male who was diagnosed with CML in

> > June

> > > > 2006.

> > > > > > My WBC at the time was 335,000. That's down to normal and all

> > my

> > > > other

> > > > > > numbers are stable.

> > > > > >

> > > > > > I was started on 400mg of Gleevec in July 2006 and stepped up

> > to

> > > > 600mg

> > > > > > in August 2006, which is my current dosage.

> > > > > >

> > > > > > Here's a copy of my latest test:

> > > > > >

> > > > > > bcr/abl,t(9;22) Translocation Quantitative Assay by RT-PCR

> > > > > >

> > > > > > BCR/ABL SOURCE NOT SPEC

> > > > > >

> > > > > > BCR/ABL QUANTITATIVE 1 Q POS

> > > > > >

> > > > > > Positive: There is evidence of the bcr/abl fusion

> > > > > >

> > > > > > trancript by RT-PCR analysis.

> > > > > >

> > > > > > This result has been reviewed and approved by

> > > > > >

> > > > > > D. B., M.D. [used initials to protect doc's identity]

> > > > > >

> > > > > > Results are reported as a ratio of bcr/abl transcripts to

> > > > > >

> > > > > > G6PDH transcripts.The limit of detection for this assay

> > > > > >

> > > > > > is 1 in 1,000 cells.

> > > > > >

> > > > > > BCR/ABL RATIO 0.00005

> > > > > >

> > > > > > BCR/ABL PREVIOUS SOURCE NOT APPL

> > > > > >

> > > > > > BCR/ABL PREVIOUS DRAW DT/TIME NOT APPL

> > > > > >

> > > > > > BCR/ABL PREVIOUS QUANT 1 NOT APPL

> > > > > >

> > > > > > BCR/ABL PREVIOUS QUANT RATIO NOT APPL

> > > > > >

> > > > > > So, my doctor said that this means a Major Molecular Response.

> > > > What

> > > > > > does that really mean? I know that's pretty good, but is that

> > as

> > > > good

> > > > > > as it can get?

> > > > > >

> > > > > > Put it in laymans terms, please. I appreciate the help.

> > > > > >

> > > > > > Sincerely,

> > > > > > Mark

> > > > > >

> > > > >

August 2, 2007

Hello Tracey, Marcos, and Mark,

I go to University of California San Diego (UCSD) which sends PCRs to

ARUP lab in Salt Lake City, Utah. The PCR report lists no lab

baseline, no log reduction, and a 1:1000 sensitivity. Yep, only three

zeros. I have already discussed this with my onc who, after contacting

someone at ARUP, is OK with the ARUP sensitivity. But I am not

comfortable with a PCR with only a 1:1000 sensitivity. So, at my own

expense, I send an additional PCR sample to OHSU in Portland which has

a 1:100,000 sensitivity. Both ARUP and OHSU use the G6PDH housekeeping

gene. My only PCR results are:

ARUP 1-07 .00076

OHSU 3-07 .083

ARUP 5-07 .00021

OHSU 6-07 .079

Though I haven't had a PCR at both ARUP and OHSU done the same month,

you still can see that the ARUP results and the OHSU results are not

similar. I do so wish that UCSD contracted with a lab with a more

sensitve quantitative PCR or let me send my sample to a lab with a

1:100,000 sensitivy, but as they do neither, I will eat the cost and

send additional samples to OHSU.

JoAnn

Dx: 8/06

Gleevec 400 mg.

> >

> > Hi Mark and Marcos,

> >

> > Anytime a number is that low it's a good thing but I'm not sure how

> > significant it is if the PCR's sensitivity was only 1 in 1,000.

> >

> > By definition, the famous 3 log reduction that we're all aiming for

> > (which is how they define a major molecular response) , is a

> > reduction in transcripts by 1000 fold. Now if someone is still

> > positive on a test that only has a sensitivity of 1,000, would that

> > not mean that their reduction is less than a 1000?

> >

> > As I've stated in previous posts, math is hardly my strong suit but I

> > do know that the experts have said that PCR's with sensitivities of

> > less than 1 in 100,000 are unreliable and give little information.

> >

> > Mark, I would suggest that you ask if you can send your samples to

> > another lab where they do more sensitive testing and this way you'll

> > know exactly where you stand.

> >

> > Tracey

August 2, 2007

Hi JoAnn,

Thanks for the information. From what my hematologists here (California) and

in France told me they are trying to get some standardization of the

molecular monitoring, but it looks that there's still a lot to be done.

There is about a factor 100 between you results from ARUP and OSHU. What

does the OSHU report says ? For what it costs you should have some detailed

information.

Marcos.

On 8/2/07, basuinokelly2002 <basuinokelly@...> wrote:

>

> Hello Tracey, Marcos, and Mark,

>

> I go to University of California San Diego (UCSD) which sends PCRs to

> ARUP lab in Salt Lake City, Utah. The PCR report lists no lab

> baseline, no log reduction, and a 1:1000 sensitivity. Yep, only three

> zeros. I have already discussed this with my onc who, after contacting

> someone at ARUP, is OK with the ARUP sensitivity. But I am not

> comfortable with a PCR with only a 1:1000 sensitivity. So, at my own

> expense, I send an additional PCR sample to OHSU in Portland which has

> a 1:100,000 sensitivity. Both ARUP and OHSU use the G6PDH housekeeping

> gene. My only PCR results are:

>

> ARUP 1-07 .00076

> OHSU 3-07 .083

> ARUP 5-07 .00021

> OHSU 6-07 .079

>

> Though I haven't had a PCR at both ARUP and OHSU done the same month,

> you still can see that the ARUP results and the OHSU results are not

> similar. I do so wish that UCSD contracted with a lab with a more

> sensitve quantitative PCR or let me send my sample to a lab with a

> 1:100,000 sensitivy, but as they do neither, I will eat the cost and

> send additional samples to OHSU.

>

> JoAnn

> Dx: 8/06

> Gleevec 400 mg.

>

> > >

> > > Hi Mark and Marcos,

> > >

> > > Anytime a number is that low it's a good thing but I'm not sure how

> > > significant it is if the PCR's sensitivity was only 1 in 1,000.

> > >

> > > By definition, the famous 3 log reduction that we're all aiming for

> > > (which is how they define a major molecular response) , is a

> > > reduction in transcripts by 1000 fold. Now if someone is still

> > > positive on a test that only has a sensitivity of 1,000, would that

> > > not mean that their reduction is less than a 1000?

> > >

> > > As I've stated in previous posts, math is hardly my strong suit but I

> > > do know that the experts have said that PCR's with sensitivities of

> > > less than 1 in 100,000 are unreliable and give little information.

> > >

> > > Mark, I would suggest that you ask if you can send your samples to

> > > another lab where they do more sensitive testing and this way you'll

> > > know exactly where you stand.

> > >

> > > Tracey

>

--

Marcos Perreau Guimaraes

Suppes Brain Lab

Ventura Hall - CSLI

Stanford University

220 Panama street

Stanford CA 94305-4101

650 614 2305

650 630 5015 (cell)

marcospg@...

montereyunderwater@...

www.stanford.edu/~marcospg/

August 2, 2007

Hi Joann--

Do you mind if I ask how much your PCR tests cost if you go through OHSU?

My husband is the CML patient, we just were at OHSU with Dr. Druker one week

ago today, for a consultation. We, too, live in Southern Cal (Long Beach

area), and have Kaiser as insurance. Kaiser did not cover the Dr. Druker

visit as my husband's onc would not give us a direct referral to see him. We

understand that healthcare is really just " big business " , so we opted to

still go see Dr. Druker and pay out of our pocket. I am interested in how

much a PCR test would cost if we also paid out of our pocket...just

wondering.

I guess the next question is that we should find out from Kaiser, which lab

they use--right? I dont even know how to go about finding that out...seems

like our onc wouldnt know that...is that a question for the medical records

dept., or the lab?

Thanks!

>From: " basuinokelly2002 " <basuinokelly@...>

>Reply-

>

>Subject: Re: [ ] Major Molecular Response

>Date: Thu, 02 Aug 2007 16:57:50 -0000

>

>Hello Tracey, Marcos, and Mark,

>

>I go to University of California San Diego (UCSD) which sends PCRs to

>ARUP lab in Salt Lake City, Utah. The PCR report lists no lab

>baseline, no log reduction, and a 1:1000 sensitivity. Yep, only three

>zeros. I have already discussed this with my onc who, after contacting

>someone at ARUP, is OK with the ARUP sensitivity. But I am not

>comfortable with a PCR with only a 1:1000 sensitivity. So, at my own

>expense, I send an additional PCR sample to OHSU in Portland which has

>a 1:100,000 sensitivity. Both ARUP and OHSU use the G6PDH housekeeping

>gene. My only PCR results are:

>

>ARUP 1-07 .00076

>OHSU 3-07 .083

>ARUP 5-07 .00021

>OHSU 6-07 .079

>

>Though I haven't had a PCR at both ARUP and OHSU done the same month,

>you still can see that the ARUP results and the OHSU results are not

>similar. I do so wish that UCSD contracted with a lab with a more

>sensitve quantitative PCR or let me send my sample to a lab with a

>1:100,000 sensitivy, but as they do neither, I will eat the cost and

>send additional samples to OHSU.

>

>JoAnn

>Dx: 8/06

>Gleevec 400 mg.

>

> > >

> > > Hi Mark and Marcos,

> > >

> > > Anytime a number is that low it's a good thing but I'm not sure how

> > > significant it is if the PCR's sensitivity was only 1 in 1,000.

> > >

> > > By definition, the famous 3 log reduction that we're all aiming for

> > > (which is how they define a major molecular response) , is a

> > > reduction in transcripts by 1000 fold. Now if someone is still

> > > positive on a test that only has a sensitivity of 1,000, would that

> > > not mean that their reduction is less than a 1000?

> > >

> > > As I've stated in previous posts, math is hardly my strong suit but I

> > > do know that the experts have said that PCR's with sensitivities of

> > > less than 1 in 100,000 are unreliable and give little information.

> > >

> > > Mark, I would suggest that you ask if you can send your samples to

> > > another lab where they do more sensitive testing and this way you'll

> > > know exactly where you stand.

> > >

> > > Tracey

>

_________________________________________________________________

More photos, more messages, more storage—get 2GB with Windows Live Hotmail.

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_mini_2G_0507

August 2, 2007

This all sounds correct....not that you need me to validate this info! But,

we too were amazed at these numbers. My husband and I just spent 2.5 hours

with Dr. Druker at OHSU last week, and he too was telling us these

statistics. Seems like pretty awesome results, if you can reach MMR in the

first 18 months, or CCR at 12 months! I think that for some reason, alot of

people dont know these statistics, we need to broadcast them more...thanks

for doing so, Marcos.

Regards,

Cervera

>From: " Marcos Perreau Guimaraes " <montereyunderwater@...>

>Reply-

>

>Subject: Re: [ ] Major Molecular Response

>Date: Thu, 2 Aug 2007 09:17:42 -0700

>

>Hi Mark,

>The followup of the IRIS patients (from initial clinical trials to last

>year) shows that 100% of these people that reach MMR in the 1st 18 months

>of

>treatment have no disease progression in 5 years (going from chronic phase

>to more advanced accelerated or blast phases). For the people that reach

>CCR

>at 12 month 97% have no disease progression in 5 years. The other very good

>thing is the available data show the odds of having cml progressing

>decrease

>with time : longer you stay in remission, better are the chances of staying

>in remission. Here's a link to the IRIS 5 year update slides from Novartis

>:

>http://www.glivec.com/pdfs/2-IRIS-5YearUpdate.pdf

>

>For your PCR test you should ask your doctor, I agree with Tracey, 1:1000

>is

>not good enough.

>Marcos.

>

>On 8/2/07, markostapiak <no_reply > wrote:

> >

> > Hi,

> >

> > I'm so glad that folks have chimed in on this one. I double checked my

> > PCR results, and they report 1:1000 sensitivity ratio (sensitivity

> > ratio? Is that the correct terminology?). I'll have to ask my doctor.

> >

> > When I go in for a check up in September, I'll ask him all the

> > questions that you've raised, as well as discuss the answers you've

> > offered, especially one mentioning that a 3log reduction means

> > " virtually no chance of relapse. " Truly?

> >

> > This is pretty confusing stuff.

> >

> > Sincerely,

> > Mark

> >

> > > > > > >

> > > > > > > Hello all,

> > > > > > >

> > > > > > > I'm a 29 year old white male who was diagnosed with CML in

> > > June

> > > > > 2006.

> > > > > > > My WBC at the time was 335,000. That's down to normal and all

> > > my

> > > > > other

> > > > > > > numbers are stable.

> > > > > > >

> > > > > > > I was started on 400mg of Gleevec in July 2006 and stepped up

> > > to

> > > > > 600mg

> > > > > > > in August 2006, which is my current dosage.

> > > > > > >

> > > > > > > Here's a copy of my latest test:

> > > > > > >

> > > > > > > bcr/abl,t(9;22) Translocation Quantitative Assay by RT-PCR

> > > > > > >

> > > > > > > BCR/ABL SOURCE NOT SPEC

> > > > > > >

> > > > > > > BCR/ABL QUANTITATIVE 1 Q POS

> > > > > > >

> > > > > > > Positive: There is evidence of the bcr/abl fusion

> > > > > > >

> > > > > > > trancript by RT-PCR analysis.

> > > > > > >

> > > > > > > This result has been reviewed and approved by

> > > > > > >

> > > > > > > D. B., M.D. [used initials to protect doc's identity]

> > > > > > >

> > > > > > > Results are reported as a ratio of bcr/abl transcripts to

> > > > > > >

> > > > > > > G6PDH transcripts.The limit of detection for this assay

> > > > > > >

> > > > > > > is 1 in 1,000 cells.

> > > > > > >

> > > > > > > BCR/ABL RATIO 0.00005

> > > > > > >

> > > > > > > BCR/ABL PREVIOUS SOURCE NOT APPL

> > > > > > >

> > > > > > > BCR/ABL PREVIOUS DRAW DT/TIME NOT APPL

> > > > > > >

> > > > > > > BCR/ABL PREVIOUS QUANT 1 NOT APPL

> > > > > > >

> > > > > > > BCR/ABL PREVIOUS QUANT RATIO NOT APPL

> > > > > > >

> > > > > > > So, my doctor said that this means a Major Molecular Response.

> > > > > What

> > > > > > > does that really mean? I know that's pretty good, but is that

> > > as

> > > > > good

> > > > > > > as it can get?

> > > > > > >

> > > > > > > Put it in laymans terms, please. I appreciate the help.

> > > > > > >

> > > > > > > Sincerely,

> > > > > > > Mark

> > > > > > >

> > > > > >

August 2, 2007

Hi ,

I also have Kaiser (I am in Northern California, in Palo Alto) and for

me they send the samples to Stanford Hospital. I get a copy of the

report from Stanford, that has number of p210 copies, ratio, baseline

and log reduction. Could you also give an idea of the cost to see Dr

Drucker ? I may be interested on doing that.

Marcos.

On 8/2/07, Cervera <weez_555@...> wrote:

> Hi Joann--

> Do you mind if I ask how much your PCR tests cost if you go through OHSU?

> My husband is the CML patient, we just were at OHSU with Dr. Druker one week

> ago today, for a consultation. We, too, live in Southern Cal (Long Beach

> area), and have Kaiser as insurance. Kaiser did not cover the Dr. Druker

> visit as my husband's onc would not give us a direct referral to see him. We

> understand that healthcare is really just " big business " , so we opted to

> still go see Dr. Druker and pay out of our pocket. I am interested in how

> much a PCR test would cost if we also paid out of our pocket...just

> wondering.

>

> I guess the next question is that we should find out from Kaiser, which lab

> they use--right? I dont even know how to go about finding that out...seems

> like our onc wouldnt know that...is that a question for the medical records

> dept., or the lab?

>

> Thanks!

>

> >From: " basuinokelly2002 " <basuinokelly@...>

> >Reply-

> >

> >Subject: Re: [ ] Major Molecular Response

> >Date: Thu, 02 Aug 2007 16:57:50 -0000

> >

> >Hello Tracey, Marcos, and Mark,

> >

> >I go to University of California San Diego (UCSD) which sends PCRs to

> >ARUP lab in Salt Lake City, Utah. The PCR report lists no lab

> >baseline, no log reduction, and a 1:1000 sensitivity. Yep, only three

> >zeros. I have already discussed this with my onc who, after contacting

> >someone at ARUP, is OK with the ARUP sensitivity. But I am not

> >comfortable with a PCR with only a 1:1000 sensitivity. So, at my own

> >expense, I send an additional PCR sample to OHSU in Portland which has

> >a 1:100,000 sensitivity. Both ARUP and OHSU use the G6PDH housekeeping

> >gene. My only PCR results are:

> >

> >ARUP 1-07 .00076

> >OHSU 3-07 .083

> >ARUP 5-07 .00021

> >OHSU 6-07 .079

> >

> >Though I haven't had a PCR at both ARUP and OHSU done the same month,

> >you still can see that the ARUP results and the OHSU results are not

> >similar. I do so wish that UCSD contracted with a lab with a more

> >sensitve quantitative PCR or let me send my sample to a lab with a

> >1:100,000 sensitivy, but as they do neither, I will eat the cost and

> >send additional samples to OHSU.

> >

> >JoAnn

> >Dx: 8/06

> >Gleevec 400 mg.

> >

> > > >

> > > > Hi Mark and Marcos,

> > > >

> > > > Anytime a number is that low it's a good thing but I'm not sure how

> > > > significant it is if the PCR's sensitivity was only 1 in 1,000.

> > > >

> > > > By definition, the famous 3 log reduction that we're all aiming for

> > > > (which is how they define a major molecular response) , is a

> > > > reduction in transcripts by 1000 fold. Now if someone is still

> > > > positive on a test that only has a sensitivity of 1,000, would that

> > > > not mean that their reduction is less than a 1000?

> > > >

> > > > As I've stated in previous posts, math is hardly my strong suit but I

> > > > do know that the experts have said that PCR's with sensitivities of

> > > > less than 1 in 100,000 are unreliable and give little information.

> > > >

> > > > Mark, I would suggest that you ask if you can send your samples to

> > > > another lab where they do more sensitive testing and this way you'll

> > > > know exactly where you stand.

> > > >

> > > > Tracey

> >

>

> _________________________________________________________________

> More photos, more messages, more storage—get 2GB with Windows Live Hotmail.

>

http://imagine-windowslive.com/hotmail/?locale=en-us & ocid=TXT_TAGHM_migration_HM\

_mini_2G_0507

>

August 2, 2007

Marcos--

Our cost for the visit was $500. Probably the best $500 we have ever spent!

Dr. Druker now has all of of 's records and, if need be, he will answer

" out of the norm " questions that maybe 's onc cannot answer. Dr. Druker

is an amazing man whose mission is to cure CML, so he likes to gather all

info he can. The experience was an amazing one for both and I.

Also, we are planning on moving back up to Northern Cal in the next 6-9

months and have already started researching docs up there. Most likely I am

going to try and keep my job, in which case I will have Kaiser Northern Cal

coverage. I have contacted Dr. Neil Shah (Dr. Druker recommended him), he is

at UCSF. He has said that he definitely could be 's specialist. However,

the insurance thing...dont know how that would work yet. Do you see a Kaiser

general onc and then consult with specialists when need be?

>From: " Marcos Perreau Guimaraes " <montereyunderwater@...>

>Reply-

>

>Subject: Re: [ ] Major Molecular Response

>Date: Thu, 2 Aug 2007 11:06:52 -0700

>

>Hi ,

>I also have Kaiser (I am in Northern California, in Palo Alto) and for

>me they send the samples to Stanford Hospital. I get a copy of the

>report from Stanford, that has number of p210 copies, ratio, baseline

>and log reduction. Could you also give an idea of the cost to see Dr

>Drucker ? I may be interested on doing that.

>Marcos.

>

>On 8/2/07, Cervera <weez_555@...> wrote:

> > Hi Joann--

> > Do you mind if I ask how much your PCR tests cost if you go through

>OHSU?

> > My husband is the CML patient, we just were at OHSU with Dr. Druker one

>week

> > ago today, for a consultation. We, too, live in Southern Cal (Long Beach

> > area), and have Kaiser as insurance. Kaiser did not cover the Dr. Druker

> > visit as my husband's onc would not give us a direct referral to see

>him. We

> > understand that healthcare is really just " big business " , so we opted to

> > still go see Dr. Druker and pay out of our pocket. I am interested in

>how

> > much a PCR test would cost if we also paid out of our pocket...just

> > wondering.

> >

> > I guess the next question is that we should find out from Kaiser, which

>lab

> > they use--right? I dont even know how to go about finding that

>out...seems

> > like our onc wouldnt know that...is that a question for the medical

>records

> > dept., or the lab?

> >

> > Thanks!

> >

> > >From: " basuinokelly2002 " <basuinokelly@...>

> > >Reply-

> > >

> > >Subject: Re: [ ] Major Molecular Response

> > >Date: Thu, 02 Aug 2007 16:57:50 -0000

> > >

> > >Hello Tracey, Marcos, and Mark,

> > >

> > >I go to University of California San Diego (UCSD) which sends PCRs to

> > >ARUP lab in Salt Lake City, Utah. The PCR report lists no lab

> > >baseline, no log reduction, and a 1:1000 sensitivity. Yep, only three

> > >zeros. I have already discussed this with my onc who, after contacting

> > >someone at ARUP, is OK with the ARUP sensitivity. But I am not

> > >comfortable with a PCR with only a 1:1000 sensitivity. So, at my own

> > >expense, I send an additional PCR sample to OHSU in Portland which has

> > >a 1:100,000 sensitivity. Both ARUP and OHSU use the G6PDH housekeeping

> > >gene. My only PCR results are:

> > >

> > >ARUP 1-07 .00076

> > >OHSU 3-07 .083

> > >ARUP 5-07 .00021

> > >OHSU 6-07 .079

> > >

> > >Though I haven't had a PCR at both ARUP and OHSU done the same month,

> > >you still can see that the ARUP results and the OHSU results are not

> > >similar. I do so wish that UCSD contracted with a lab with a more

> > >sensitve quantitative PCR or let me send my sample to a lab with a

> > >1:100,000 sensitivy, but as they do neither, I will eat the cost and

> > >send additional samples to OHSU.

> > >

> > >JoAnn

> > >Dx: 8/06

> > >Gleevec 400 mg.

> > >

> > > > >

> > > > > Hi Mark and Marcos,

> > > > >

> > > > > Anytime a number is that low it's a good thing but I'm not sure

>how

> > > > > significant it is if the PCR's sensitivity was only 1 in 1,000.

> > > > >

> > > > > By definition, the famous 3 log reduction that we're all aiming

>for

> > > > > (which is how they define a major molecular response) , is a

> > > > > reduction in transcripts by 1000 fold. Now if someone is still

> > > > > positive on a test that only has a sensitivity of 1,000, would

>that

> > > > > not mean that their reduction is less than a 1000?

> > > > >

> > > > > As I've stated in previous posts, math is hardly my strong suit

>but I

> > > > > do know that the experts have said that PCR's with sensitivities

>of

> > > > > less than 1 in 100,000 are unreliable and give little information.

> > > > >

> > > > > Mark, I would suggest that you ask if you can send your samples to

> > > > > another lab where they do more sensitive testing and this way

>you'll

> > > > > know exactly where you stand.

> > > > >

> > > > > Tracey

> > >

> >

> > _________________________________________________________________

> > More photos, more messages, more storage—get 2GB with Windows Live

>Hotmail.

> >

>http://imagine-windowslive.com/hotmail/?locale=en-us & ocid=TXT_TAGHM_migration_H\

M_mini_2G_0507

> >

August 2, 2007

Thanks for the information. That's a lot more affordable than what I

thougth (Stanford cost a lot more). I may see him if I am still

failing MMR in the next year. I have Dr Feiner at Santa Clara Kaiser

(near San ), I think they are ok as long as I stay in good

remission.

Cheers,

Marcos.

On 8/2/07, Cervera <weez_555@...> wrote:

> Marcos--

> Our cost for the visit was $500. Probably the best $500 we have ever spent!

> Dr. Druker now has all of of 's records and, if need be, he will answer

> " out of the norm " questions that maybe 's onc cannot answer. Dr. Druker

> is an amazing man whose mission is to cure CML, so he likes to gather all

> info he can. The experience was an amazing one for both and I.

>

> Also, we are planning on moving back up to Northern Cal in the next 6-9

> months and have already started researching docs up there. Most likely I am

> going to try and keep my job, in which case I will have Kaiser Northern Cal

> coverage. I have contacted Dr. Neil Shah (Dr. Druker recommended him), he is

> at UCSF. He has said that he definitely could be 's specialist. However,

> the insurance thing...dont know how that would work yet. Do you see a Kaiser

> general onc and then consult with specialists when need be?

>

> >From: " Marcos Perreau Guimaraes " <montereyunderwater@...>

> >Reply-

> >

> >Subject: Re: [ ] Major Molecular Response

> >Date: Thu, 2 Aug 2007 11:06:52 -0700

> >

> >Hi ,

> >I also have Kaiser (I am in Northern California, in Palo Alto) and for

> >me they send the samples to Stanford Hospital. I get a copy of the

> >report from Stanford, that has number of p210 copies, ratio, baseline

> >and log reduction. Could you also give an idea of the cost to see Dr

> >Drucker ? I may be interested on doing that.

> >Marcos.

> >

> >On 8/2/07, Cervera <weez_555@...> wrote:

> > > Hi Joann--

> > > Do you mind if I ask how much your PCR tests cost if you go through

> >OHSU?

> > > My husband is the CML patient, we just were at OHSU with Dr. Druker one

> >week

> > > ago today, for a consultation. We, too, live in Southern Cal (Long Beach

> > > area), and have Kaiser as insurance. Kaiser did not cover the Dr. Druker

> > > visit as my husband's onc would not give us a direct referral to see

> >him. We

> > > understand that healthcare is really just " big business " , so we opted to

> > > still go see Dr. Druker and pay out of our pocket. I am interested in

> >how

> > > much a PCR test would cost if we also paid out of our pocket...just

> > > wondering.

> > >

> > > I guess the next question is that we should find out from Kaiser, which

> >lab

> > > they use--right? I dont even know how to go about finding that

> >out...seems

> > > like our onc wouldnt know that...is that a question for the medical

> >records

> > > dept., or the lab?

> > >

> > > Thanks!

> > >

> > > >From: " basuinokelly2002 " <basuinokelly@...>

> > > >Reply-

> > > >

> > > >Subject: Re: [ ] Major Molecular Response

> > > >Date: Thu, 02 Aug 2007 16:57:50 -0000

> > > >

> > > >Hello Tracey, Marcos, and Mark,

> > > >

> > > >I go to University of California San Diego (UCSD) which sends PCRs to

> > > >ARUP lab in Salt Lake City, Utah. The PCR report lists no lab

> > > >baseline, no log reduction, and a 1:1000 sensitivity. Yep, only three

> > > >zeros. I have already discussed this with my onc who, after contacting

> > > >someone at ARUP, is OK with the ARUP sensitivity. But I am not

> > > >comfortable with a PCR with only a 1:1000 sensitivity. So, at my own

> > > >expense, I send an additional PCR sample to OHSU in Portland which has

> > > >a 1:100,000 sensitivity. Both ARUP and OHSU use the G6PDH housekeeping

> > > >gene. My only PCR results are:

> > > >

> > > >ARUP 1-07 .00076

> > > >OHSU 3-07 .083

> > > >ARUP 5-07 .00021

> > > >OHSU 6-07 .079

> > > >

> > > >Though I haven't had a PCR at both ARUP and OHSU done the same month,

> > > >you still can see that the ARUP results and the OHSU results are not

> > > >similar. I do so wish that UCSD contracted with a lab with a more

> > > >sensitve quantitative PCR or let me send my sample to a lab with a

> > > >1:100,000 sensitivy, but as they do neither, I will eat the cost and

> > > >send additional samples to OHSU.

> > > >

> > > >JoAnn

> > > >Dx: 8/06

> > > >Gleevec 400 mg.

> > > >

> > > > > >

> > > > > > Hi Mark and Marcos,

> > > > > >

> > > > > > Anytime a number is that low it's a good thing but I'm not sure

> >how

> > > > > > significant it is if the PCR's sensitivity was only 1 in 1,000.

> > > > > >

> > > > > > By definition, the famous 3 log reduction that we're all aiming

> >for

> > > > > > (which is how they define a major molecular response) , is a

> > > > > > reduction in transcripts by 1000 fold. Now if someone is still

> > > > > > positive on a test that only has a sensitivity of 1,000, would

> >that

> > > > > > not mean that their reduction is less than a 1000?

> > > > > >

> > > > > > As I've stated in previous posts, math is hardly my strong suit

> >but I

> > > > > > do know that the experts have said that PCR's with sensitivities

> >of

> > > > > > less than 1 in 100,000 are unreliable and give little information.

> > > > > >

> > > > > > Mark, I would suggest that you ask if you can send your samples to

> > > > > > another lab where they do more sensitive testing and this way

> >you'll

> > > > > > know exactly where you stand.

> > > > > >

> > > > > > Tracey

> > > >

> > >

> > > _________________________________________________________________

> > > More photos, more messages, more storage—get 2GB with Windows Live

> >Hotmail.

> > >

>

>http://imagine-windowslive.com/hotmail/?locale=en-us & ocid=TXT_TAGHM_migration_H\

M_mini_2G_0507

> > >

August 3, 2007

Hello,

I just have a Quantitative RT-PCR Analysis done early July. On the

report, it has a comment of " This test can detect the BCR-ABL

translocations e13a2, e14a2, e1a2 to a sensitivity level of > 1 in

100,000 transcripts (0.001%).

> > >

> > > Hi Mark and Marcos,

> > >

> > > Anytime a number is that low it's a good thing but I'm not

sure how

> > > significant it is if the PCR's sensitivity was only 1 in 1,000.

> > >

> > > By definition, the famous 3 log reduction that we're all

aiming for

> > > (which is how they define a major molecular response) , is a

> > > reduction in transcripts by 1000 fold. Now if someone is still

> > > positive on a test that only has a sensitivity of 1,000, would

that

> > > not mean that their reduction is less than a 1000?

> > >

> > > As I've stated in previous posts, math is hardly my strong

suit but I

> > > do know that the experts have said that PCR's with

sensitivities of

> > > less than 1 in 100,000 are unreliable and give little

information.

> > >

> > > Mark, I would suggest that you ask if you can send your

samples to

> > > another lab where they do more sensitive testing and this way

you'll

> > > know exactly where you stand.

> > >

> > > Tracey

>

August 4, 2007

Yes,

I got my results from that lab in Salt Lake City. So, I'll talk to my

onc. about sending them elsewhere.

Thanks,

Mark

> > >

> > > Hi Mark and Marcos,

> > >

> > > Anytime a number is that low it's a good thing but I'm not sure how

> > > significant it is if the PCR's sensitivity was only 1 in 1,000.

> > >

> > > By definition, the famous 3 log reduction that we're all aiming for

> > > (which is how they define a major molecular response) , is a

> > > reduction in transcripts by 1000 fold. Now if someone is still

> > > positive on a test that only has a sensitivity of 1,000, would that

> > > not mean that their reduction is less than a 1000?

> > >

> > > As I've stated in previous posts, math is hardly my strong suit

but I

> > > do know that the experts have said that PCR's with sensitivities of

> > > less than 1 in 100,000 are unreliable and give little information.

> > >

> > > Mark, I would suggest that you ask if you can send your samples to

> > > another lab where they do more sensitive testing and this way you'll

> > > know exactly where you stand.

> > >

> > > Tracey

>

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Re: Major Molecular Response

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