Guest guest Posted February 20, 2006 Report Share Posted February 20, 2006 Hi Sheila, It sounds like you need a new doctor. Your doctor should have told you that there is a margin of error with the FISH test. Depending on which type of probe they used, it could be as high as 7% or even 10% (with a single fusion probe). The newer double fusion probes have a smaller false positive rate (like 2%-5%) so your 3% is very likely a complete zero which means you are very likely in a cytogenetic remission (they don't really use the word remission, it's been replaced with " response " ). The log reduction you ask about can only be determined with a PCR test. This test will look at many, many more cells than the 20 you would see from a bone marrow biopsy exam or the 200 you would see in a FISH test. PCR's aren't standardized so depending on the lab, you could be looking at 10,000 to 1 million cells. The lab will have a formula to determine if you've had the famous 3 log reduction which is the goal in Gleevec therapy. If you've recently been diagnosed (within the last year or two) you should have had a PCR at diagnosis but if not, the lab should have what they would consider the average number on diagnosis then the reduction is calculated from there. Basically though, each log is a 10 fold reduction in numbers (the decimal moves one spot to the right with each log reduction.....so if you start at 10, a one log reduction would be 1.0 then a two log reduction would be 0.10 and the three log reduction would be 0.01). You say your WBC and ANC are very low. How low are they? It's perfectly normal for them to be low to a certain extent. If your ANC is below 1 then the protocol is to stop Gleevec treatment until the ANC bounces back up to 1. Many inexperienced doctors will panic when the ANC drops a bit and make their patients stop Gleevec when there really isn't any need to. If you continue to have chronically low counts, there are options you can consider. One is to take Neupogen which is a medication that helps boost your neutrophils so you can stay on the Gleevec without interruption. There is a difference between being resistant and being sensitive. If you're resistant, it means that the Gleevec isn't working. If you're sensitive, it means it's working fine. If your FISH was just 3%, I'd say Gleevec is working fine for you. You should have another BMB to confirm that you're in CCR (complete cytogenetic response) and from there, you need to have regular PCR's every 3 months. I hope I haven't confused you. There's an FAQ and a glossary in the files section (at the left of the homepage) that you may want to check out. If you have any more questions, please let us know. Take care, Tracey Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2006 Report Share Posted February 21, 2006 Hi Sheila, i too get confused with all this log reduction so im sure if you see some of the older ones online then im sure they will explane to you about log reduction (zavie, john, tracey or lynn.) Sounds to me Gleevec is doing the job for you which is great but about being round for decades. I saw Tim thursday and he mentioned to me that the good news about gleevec that they think it will help people to be around for 20 years...so dont stress yourself out...if you cope with gleevec and your counts keep reducing then thats great... Susie Leech Dx Nov 2002 Currently off Gleevec Quote Link to comment Share on other sites More sharing options...
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