Guest guest Posted September 24, 2008 Report Share Posted September 24, 2008 Hi Carol, It's been a number of years now that most doctors don't bother with FISH tests anymore. FISH tests just don't compare with PCR tests. A FISH test will only examine roughly 200 cells and there's a margin of error with the test that can be as high as 8% so if your husband is at 1.6%, this is as good as zero when it comes to a FISH. Unfortunately though, the FISH tells you very little about what is really going on. The experts recommend that patients get PCR's every three months with no recommendation to ever have FISH again. I've been having PCR's since 2002 and haven't had a FISH once in that time. A PCR can look at up to a million cells depending on where the test is done. This means that if you start to relapse, it will catch it many months before a FISH test will. By knowing early on, you can take action before things get out of control. The problem with PCR's though is that the tests aren't standardized so while one place might test with a sensitivity of 1 in a million cells, another place might only use 1 in 1,000. The more cells they look at, the better. What I would suggest is that you find out what the sensitivity is of the lab your husband is using. You should also know what their baseline value is for a newly diagnosed patient then you'll be able to see from his test result what kind of log reduction he's had. His result should be a number with a decimal in it. I suspect the 1/1000 figure you were given is referring to the sensitivity of the test and not his actual result but you need to clarify with the doctor. If you're not confident that your doctor is up to date on CML treatment, please find another one who is. Many of us have changed doctors because we weren't happy with the one we had. When you're dealing with your life, you can't afford to be with a doctor who doesn't know what the normal protocols are. Good luck, Tracey > > Hello, > I have posted inquiring whether or not one should have FISH vs. PCR > test. It is only because of this site that I am aware of a PCR > test. Also because of the knowledge I have gained from this site my > husband questioned his Onc. about the PCR and last time the Onc. > performed both test. > > Anyway, my husband just got a call from his Onc. and he said that the > FISH test is 1.6 (unchanged from 3 months ago) and the PCR is > 1/1000. He has been taking 800 mg of Gleevec since Jan. Dr. said > overall this looks good, but that he wanted to discuss with his > colleagues how to proceed. I assume that means continue on the same > line of treatment or change meds. > > But, I guess my question is can someone explain it all. I see you > all posting log reductions. What does the 1/1000 PCR mean? I know > with FISH the ultimate goal is to get to " 0 " . October will be 2 > years since my husband was diagnosed. Any suggestions on what we > should or should not be asking. Can someone tell me what these > numbers mean. > > Thank you, > > Carol > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 24, 2008 Report Share Posted September 24, 2008 You are right about different labs I went to Vanderbuilt Nashville Tn got ..00378.Three months later got .7 with local onc threw Lab cor. You mentioned bouncing around ,how much is that ! I got a muntaint test because I'm bouncing around still 600 Gleevec.Onc wants me to go 800 because it has been more than 24 month on Gleevec. dxt 12/2/05 Gleevec 600 last 9 months. ----- Original Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 25, 2008 Report Share Posted September 25, 2008 Thank you for the info. That helps. My husband is at JHMC and he is confident that he has a good Onc. I think we just need to ask more questions. This group helps us gain the knowledge we need to ask those questions. Thank all of you. Carol > > > > Hello, > > I have posted inquiring whether or not one should have FISH vs. PCR > > test. It is only because of this site that I am aware of a PCR > > test. Also because of the knowledge I have gained from this site > my > > husband questioned his Onc. about the PCR and last time the Onc. > > performed both test. > > > > Anyway, my husband just got a call from his Onc. and he said that > the > > FISH test is 1.6 (unchanged from 3 months ago) and the PCR is > > 1/1000. He has been taking 800 mg of Gleevec since Jan. Dr. said > > overall this looks good, but that he wanted to discuss with his > > colleagues how to proceed. I assume that means continue on the > same > > line of treatment or change meds. > > > > But, I guess my question is can someone explain it all. I see you > > all posting log reductions. What does the 1/1000 PCR mean? I know > > with FISH the ultimate goal is to get to " 0 " . October will be 2 > > years since my husband was diagnosed. Any suggestions on what we > > should or should not be asking. Can someone tell me what these > > numbers mean. > > > > Thank you, > > > > Carol > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 25, 2008 Report Share Posted September 25, 2008 tracey when a bmb is done does that reveal what the pcr test does also ? aliza yaffa **************Looking for simple solutions to your real-life financial challenges? Check out WalletPop for the latest news and information, tips and calculators. (http://www.walletpop.com/?NCID=emlcntuswall00000001) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 26, 2008 Report Share Posted September 26, 2008 Hi Aliza, A PCR test can be done on either blood from your marrow or peripheral blood (blood from your arm vein) but most doctors use the peripheral blood since it's obviously easier and less painful. The usual test that is done with a BMB is called a cytogenetic test. That's when they look at 20 cells manually. BMB's also examine the marrow itself and each of the chromosomes (not just the 9,22) so a BMB isn't done only to look for the Philadelphia chromosome, it's also done to look at the health of the marrow and the other chromosomes which you can't do with a PCR or other test. Take care, Tracey > > tracey when a bmb is done does that reveal what the pcr test does also ? > aliza yaffa > > > > **************Looking for simple solutions to your real-life financial > challenges? Check out WalletPop for the latest news and information, tips and > calculators. (http://www.walletpop.com/? NCID=emlcntuswall00000001) > > > Quote Link to comment Share on other sites More sharing options...
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