I'm new to this forum and also new to living with CML. My results don't seem to be like others I've seen online but perhaps I'm not looking in the right places.
I have gotten a PCR test which I find inscrutable. I don't understand what the numbers can mean. I've had two of these tests. The test results I receive are so simple but with no explanatory information. Here they are for anyone that can give me a hand on them: 4/02/17 (PB) 0.9; 24/05/17 (PB) -0.11
Thanks for any help.
Hi there, and welcome!
PCR is a complex topic, no doubt. Because of that we created a "Primer for patients" booklet which explains what a PCR test is, how it works and how to interpret the results.
You can download it here:
http://www.cmlsupport.org.uk/sites/default/files/qrt-pcr-primer.pdf
For your specific results, if that's the only information you've been given it's not brilliantly explained to you by your clinic. However, I would read it as your PCR results being 0.9% in February and 0.11% in May. That's a really good trend - 0.11% is just a hair's breadth outside MMR which is the "safe haven" zone. I am not sure that the "PB" means, though.
The next time you see your clinician you should ask whether your PCR results are reported on the International Scale or not. Section 4 of the booklet above explains more.
PS. when were you diagnosed? The "optimal" response is to achieve MMR within 1 year of diagnosis and you are basically there according to that result (assuming it is on the International Scale).
David.
Hi and welcome,
I second David's remarks... you are right on track for a good response to therapy. You can ask your clinician if your PCR results are from a Lab that is tied to the International Standard. If you are in the US then the Lab your doctor uses may not be as it depends on your health insurance - they sometimes have preferred Labs (due to cost issues). Nevertheless, you should be looking to a. stay with the same Lab if possible and b. look for a downward trend in your results, then once at MMR/MR3 (0.1) or lower you should look for stability in your results.
I think PB means peripheral blood, i.e the samples tested were taken from your blood via your veins and not a sample from your marrow. This is normal now as samples from the peripheral blood are much less invasive and give accurate PCR results. Marrow samples are less commonly used (apart to confirm diagnosis or to rule out disease progression) as they are very invasive (cause pain) and with the improvements in PCR technology there is no longer any need to make patients suffer unduly.
I hope you find the booklet (PCR primer ) helpful. If you need to ask more questions then do not hesitate.
Sandy
Thank you so much David and Sandy.
I had a confirmed diagnosis in March from a Bone marrow test. I live in Saskatchewan, Canada. I'm not certain if they use the international system or not as all cytogenetic testing is done in British Columbia (another region in Canada). I am taking 400 mg of imatinib a day.
Thanks for the link to the Primer, David. I'm going through it now.
PB does mean peripheral blood, I'm certain, as there is a blank box with BM next to it (presumably Bone Marrow). So the samples, which were taken from my veins, have the values I mentioned earlier.
However, the values are actually 0.9 in February and -0.11 (negative) in May. Which gives me the indication that they aren't using the international scale. I'm not sure how you can go from positive to negative exactly.
In any case, I really appreciate your comments and the time spent answering my query.
You can't go negative for a BCR-Abl PCR test. 0 is as low as it goes, whether on the international scale or not.
Perhaps it was just a typo, or someone using the "-" symbol as a sort of bullet point? I would imagine it was just 0.11%.
Do ask at your next appointment whether the results are on the International Scale or not, it's very useful to know as it allows you to make direct comparisons about your response to treatment goals.
David.
