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What's PCR testing?

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PCR testing can detect very small amounts of genetic material in a biospecimen

sample, such as a gene translocation t(14:18) which produces pro-survival

protein, BCL-2, in many lymphomas.

When the PCR test is negative (a good result), it means that there may be no

abnormal cells in the blood or marrow, which might be described as a molecular

remission.

Analogy: A standard bone marrow test is like taking a sample of a pool with a

scoop net in the dark. The test is only conclusive if leaves are found, because

the sample may have missed leaves floating elsewhere in the larger pool. PCR

testing is like examining the same sample for tiny fragments

of substances that exist only in leaves. Thus, a negative finding with PCR

testing provides greater confidence that the bone marrow is clear of the

abnormal cells.

The clinical significance of a molecular remission is still not clear, but

achieving this kind or response has been associated with longer duration of

response among the participants in some studies. PCR tests are generally given

after a complete response to treatment has been determined using CT and a bone

marrow biopsy, mainly in clinical trials.

The analytical sensitivity of PCR is 1 tumor cell in 100,000 normal cells.

A limitation of the test is that it can only show the status of the compartment

tested: the blood or marrow. A conversion to negative appears to be a good

prognostic indicator, but not definitively, because the test can't determine the

t:14:18 status in lymph nodes and other areas.

See http://www.lymphomation.org/tests-scans.htm#bcl-2

Karl

www.lymphomation.org

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