Re: Tracey and Zavie, help me understand it, please!!!

[Guest guest]

O!!! YIPPEEE!!!

Number 1270 in the Zero Club

Zavie

Zavie (age 71)

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

3.6 log reduction Apr/08

3.6 log reduction Sep/08

3.7 log reduction Jan/09

3.8 log reduction May/09

3.8 log reduction Aug/09

e-mail: zmiller@...

Tel: 613-726-1117

Fax: 613-482-4801

Cell: 613-282-0204

ID: zaviem

_____

From: [mailto: ] On Behalf Of

llokl_777

Sent: September 3, 2009 12:06 AM

Subject: [ ] Tracey and Zavie, help me understand it, please!!!

I visited Dr. Druker on August 20th. He did additional PCR test as my last

PCR test on July 31st was incomplete (I'm very disappointed by my local

onc). Today Carolyn, Dr. Druker's assistant, posted FISH results on My Chart

(see below). Can you, please, help me to translate it from medical terms to

" normal " language?

Thank you in advance,

Lilia.

P.S. Back to our group discussion about frequency of PCR test. I asked about

it Dr. Druker and his recommendation was - every three months. I'll follow

his recommendation even if I would need to change local doctor every three

months. Unfortunately, my doc demands to perform PCR every six months

despite my request for three months interval.

CHROMOSOME REPORT Hem/Onc Blood: Full Study/FISH

** THIS IS AN AMENDED REPORT **

Supplemental indications: Chronic Myelogenous Leukemia FISH Results:

Normal Chromosome Results: See below

KARYOTYPE RESULTS: See below

IMPRESSIONS AND RECOMMENDATIONS:

Only three metaphase cells were found in all available material - they

appeared normal female.

Fluorescent in situ hybridization (FISH) was performed using the Abbott

BCR/ABL dual fusion and ASS probes. Of 200 interphase cells scored, 189

had the normal 2 green/ 2 red/ 2 aqua signal pattern; 11 cells had a 1

green/ 1 red/ 1 yellow/ 2 aqua signal pattern. Since these cells were not

deleted for ASS, the yellow signal is assumed to be artifact. No evidence

for BCR/ABL fusion.

[Note: Interphase FISH analysis is not intended to stand alone, but rather

to provide supplemental information to routine cytogenetic studies.]

Thank you very much for your referral. If you have any questions regarding

this report or future cytogenetic testing issues, please feel free to

contact us.

CYTOGENETIC ANALYSIS SUMMARY:

Number of Cells Analyzed: 3 Banding Level: <400

Number of Cells Karyotyped: 1 Banding Method: GTW

INTERPHASE FISH ANALYSIS SUMMARY:

Cells Scored: 200 Probe(s): Abbott BCR (22q11.2) (SG) / ABL (9q34)

(SO) + ASS (9q34) SA)

This test was developed and its performance characteristics determined by

the OHSU Cytogenetics Laboratory as required by the CLIA '88 regulations.

It has not been cleared or approved for specific uses by the U.S. Food and

Drug Administration.

Preliminary report date: FISH: 8/24/2009 Chromosomes: 8/31/2009

**Amended for typographical error - does not change interpretation**

The clinical interpretation was made by the clinical geneticist.

Rendering Diagnostician: Robb Moses MD, ABMG, FACMG

Clinical Geneticist

Electronically Signed 09/02/2009

Rendering Diagnostician: Olson PhD, ABMG, FACMG

Clinical Cytogeneticist

Electronically Signed 09/02/2009

[Guest guest]

Hi Lilia,

Sorry for taking so long to respond. I was out of town for a few days and

didn't have internet access.

Everything looks great on your report. No cancer cells were detected in either

the FISH or the BMB. I'm not sure why your bone marrow sample only yielded 3

cells (instead of the usual 20) but sometimes that happens. What matters is

that the cells they got all looked good. Whoo hooo!

I found the concluding comment very interesting where it says that " Interphase

FISH analysis is not intended to stand alone, but rather to provide supplemental

information to routine cytogenetic studies. "

We used to have a member whose doctor did only FISH tests and relied on those

results solely when making clinical decisions. This comment on your report

proves that FISH tests are not a sufficient way of monitoring patients.

Congratulations Lilia, you look like you're doing excellent on Gleevec.

Tracey

>

>

> I visited Dr. Druker on August 20th. He did additional PCR test as my last PCR

test on July 31st was incomplete (I'm very disappointed by my local onc). Today

Carolyn, Dr. Druker's assistant, posted FISH results on My Chart (see below).

Can you, please, help me to translate it from medical terms to " normal "

language?

>

> Thank you in advance,

>

> Lilia.

>

> P.S. Back to our group discussion about frequency of PCR test. I asked about

it Dr. Druker and his recommendation was - every three months. I'll follow his

recommendation even if I would need to change local doctor every three months.

Unfortunately, my doc demands to perform PCR every six months despite my request

for three months interval.

>

>

>

> CHROMOSOME REPORT Hem/Onc Blood: Full Study/FISH

> ** THIS IS AN AMENDED REPORT **

> Supplemental indications: Chronic Myelogenous Leukemia FISH Results:

> Normal Chromosome Results: See below

> KARYOTYPE RESULTS: See below

>

> IMPRESSIONS AND RECOMMENDATIONS:

> Only three metaphase cells were found in all available material - they

> appeared normal female.

>

> Fluorescent in situ hybridization (FISH) was performed using the Abbott

> BCR/ABL dual fusion and ASS probes. Of 200 interphase cells scored, 189

> had the normal 2 green/ 2 red/ 2 aqua signal pattern; 11 cells had a 1

> green/ 1 red/ 1 yellow/ 2 aqua signal pattern. Since these cells were not

> deleted for ASS, the yellow signal is assumed to be artifact. No evidence

> for BCR/ABL fusion.

>

> [Note: Interphase FISH analysis is not intended to stand alone, but rather

> to provide supplemental information to routine cytogenetic studies.]

>

> Thank you very much for your referral. If you have any questions regarding

> this report or future cytogenetic testing issues, please feel free to

> contact us.

>

> CYTOGENETIC ANALYSIS SUMMARY:

> Number of Cells Analyzed: 3 Banding Level: <400

> Number of Cells Karyotyped: 1 Banding Method: GTW

>

> INTERPHASE FISH ANALYSIS SUMMARY:

>

> Cells Scored: 200 Probe(s): Abbott BCR (22q11.2) (SG) / ABL (9q34)

> (SO) + ASS (9q34) SA)

>

>

> This test was developed and its performance characteristics determined by

> the OHSU Cytogenetics Laboratory as required by the CLIA '88 regulations.

> It has not been cleared or approved for specific uses by the U.S. Food and

> Drug Administration.

>

> Preliminary report date: FISH: 8/24/2009 Chromosomes: 8/31/2009

> **Amended for typographical error – does not change interpretation**

> The clinical interpretation was made by the clinical geneticist.

>

>

> Rendering Diagnostician: Robb Moses MD, ABMG, FACMG

> Clinical Geneticist

> Electronically Signed 09/02/2009

> Rendering Diagnostician: Olson PhD, ABMG, FACMG

> Clinical Cytogeneticist

> Electronically Signed 09/02/2009

>

[Guest guest]

Thank you for your reply. It is great to see you back. I appreciate your

clarification - these medical terms were too complex for me. I also received

additional email from Carolyn (Dr. Druker's assistant) where she put my results

in " normal language " . This is what she wrote: " ...the test did not find evidence

of CML. The additional thing was the final report including that they checked

your chromosomes. Your CML does not show up in chromosome analysis like it does

in most patients; this is why we needed to do the FISH. Everything was negative,

unable to find any evidence of CML... "

Tracey, thanks a lot again. I don't know what I would do without great support

of this group and without your help and expertise.

Love,

Lilia.

P.S. If I could frame my number in Zavie's zero club I would do that:) I don't

know why but this number does something positive to your mind.

> >

> >

> > I visited Dr. Druker on August 20th. He did additional PCR test as my last

PCR test on July 31st was incomplete (I'm very disappointed by my local onc).

Today Carolyn, Dr. Druker's assistant, posted FISH results on My Chart (see

below). Can you, please, help me to translate it from medical terms to " normal "

language?

> >

> > Thank you in advance,

> >

> > Lilia.

> >

> > P.S. Back to our group discussion about frequency of PCR test. I asked about

it Dr. Druker and his recommendation was - every three months. I'll follow his

recommendation even if I would need to change local doctor every three months.

Unfortunately, my doc demands to perform PCR every six months despite my request

for three months interval.

> >

> >

> >

> > CHROMOSOME REPORT Hem/Onc Blood: Full Study/FISH

> > ** THIS IS AN AMENDED REPORT **

> > Supplemental indications: Chronic Myelogenous Leukemia FISH Results:

> > Normal Chromosome Results: See below

> > KARYOTYPE RESULTS: See below

> >

> > IMPRESSIONS AND RECOMMENDATIONS:

> > Only three metaphase cells were found in all available material - they

> > appeared normal female.

> >

> > Fluorescent in situ hybridization (FISH) was performed using the Abbott

> > BCR/ABL dual fusion and ASS probes. Of 200 interphase cells scored, 189

> > had the normal 2 green/ 2 red/ 2 aqua signal pattern; 11 cells had a 1

> > green/ 1 red/ 1 yellow/ 2 aqua signal pattern. Since these cells were not

> > deleted for ASS, the yellow signal is assumed to be artifact. No evidence

> > for BCR/ABL fusion.

> >

> > [Note: Interphase FISH analysis is not intended to stand alone, but rather

> > to provide supplemental information to routine cytogenetic studies.]

> >

> > Thank you very much for your referral. If you have any questions regarding

> > this report or future cytogenetic testing issues, please feel free to

> > contact us.

> >

> > CYTOGENETIC ANALYSIS SUMMARY:

> > Number of Cells Analyzed: 3 Banding Level: <400

> > Number of Cells Karyotyped: 1 Banding Method: GTW

> >

> > INTERPHASE FISH ANALYSIS SUMMARY:

> >

> > Cells Scored: 200 Probe(s): Abbott BCR (22q11.2) (SG) / ABL (9q34)

> > (SO) + ASS (9q34) SA)

> >

> >

> > This test was developed and its performance characteristics determined by

> > the OHSU Cytogenetics Laboratory as required by the CLIA '88 regulations.

> > It has not been cleared or approved for specific uses by the U.S. Food and

> > Drug Administration.

> >

> > Preliminary report date: FISH: 8/24/2009 Chromosomes: 8/31/2009

> > **Amended for typographical error – does not change interpretation**

> > The clinical interpretation was made by the clinical geneticist.

> >

> >

> > Rendering Diagnostician: Robb Moses MD, ABMG, FACMG

> > Clinical Geneticist

> > Electronically Signed 09/02/2009

> > Rendering Diagnostician: Olson PhD, ABMG, FACMG

> > Clinical Cytogeneticist

> > Electronically Signed 09/02/2009

> >

>