I have the FISH study from my original bone marrow biopsy, and I THOUGHT I knew what it said, but after a year and a half, I don't think I do. Could someone translate this into 'stupid' for me?
I don't know how much these people get paid, but whatever it is, it ain't enough just for the data entry person. Whew ...
Anyway, this is exactly what the interpretation and comments section of the FISH results said.
Interpretation:
Comments:
Positive for 4 signals for the ATM gene and 3 signals for the p53 gene on chromosomes 11 and 17 respectively in 106 of 252 cells (42%).
Positive for 4 signals each for the ATM and p53 loci on chromosomes 11 and 17 respectively, in 8 of 252 cells (3.2%)
Comments:
Fluorescence in situ hybridization (F.I.S.H.) with the LSI ATM(11q22.3) SG/p53 (17p13.1) SO, LSI RB1 (13q14), LSI FGFR3/IGH {t(4:14)}, and LSI IgH/MAF {t(14;16)} probes in the panel revealed FOUR signals for the ATM gene and THREE signals for the p53 gene on the long arm of chromosome 11 and the short arm of chromosome 17 respectively, in 106 of 252 cells analyzed (42%). In addition, the analysis showed 4 signals each for the ATM and p53 genes on chromosomes 11 and 17 respectively, in 8 of 252 cells (3.2%). These findings are POSITIVE for the gain of the ATM and p53 loci on chromosomes 11 and 17 respectively. The remaining probe set revealed two signals each for chromosomes 13q14 (RB1x2), 4p16 (FGFR3x2)/14q32 (IGHx2), and 14q32 (IGHx2)/16q23 (MAFx2), and are the normal patterns for these probes. These results may reflect an underlying hyperdiploid chromosome complement which has been reported in multiple myeloma.
I am confused. Someone translate this into English major for me?
Thank you.
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dianaiad - Who do you know with myeloma?: Me
- When were you/they diagnosed?: Officially...March 2013
- Age at diagnosis: 63
Re: Does anybody here speak FISH? Can someone translate?
I think you might find a relevant post here 
"Need FISH translation," Myeloma Beacon forum discussion started March 13, 2013.
"Need FISH translation," Myeloma Beacon forum discussion started March 13, 2013.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Does anybody here speak FISH? Can someone translate?
Thank you, Multibilly ... and yes, I remember that.
The problem is that my doctors have told me that I do indeed have "high risk" because of a p17 deletion and one on 11. Indeed, Dr. B told me that just two days ago.
Now I remember the discussion here.
But two doctors - Dr. B and Dr. C - have both told me that I am 'high risk' because of the p17 deletion.
That's why I posted this stuff again.
Who's right?
The problem is that my doctors have told me that I do indeed have "high risk" because of a p17 deletion and one on 11. Indeed, Dr. B told me that just two days ago.
Now I remember the discussion here.
But two doctors - Dr. B and Dr. C - have both told me that I am 'high risk' because of the p17 deletion.
That's why I posted this stuff again.
Who's right?
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dianaiad - Who do you know with myeloma?: Me
- When were you/they diagnosed?: Officially...March 2013
- Age at diagnosis: 63
Re: Does anybody here speak FISH? Can someone translate?
Hello,
Has your doctor done a newer or separate set of tests that detected the chromosome 17 deletion? As far as I could tell, there is no mention of a deletion on chromosome 17 in the results you posted.
Has your doctor done a newer or separate set of tests that detected the chromosome 17 deletion? As far as I could tell, there is no mention of a deletion on chromosome 17 in the results you posted.
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dnalex - Name: Alex N.
- Who do you know with myeloma?: mother
- When were you/they diagnosed?: 2007
- Age at diagnosis: 56
Re: Does anybody here speak FISH? Can someone translate?
Hi Dianaiad,
From my recollection, you are a fellow Southern California Kaiser patient - Hi there! I've been reading your posts with great interest.
I was diagnosed with smoldering myeloma at Kaiser last September, after 4.5 years of MGUS. They ran the exact same set of FISH probes on me last fall and, as an aside, I was disappointed they did not run a probe to determine chromosome 1 copy number abnormalities, as it is a potential risk factor, or more probes to determine the possibility of hyperdiploidy, which is a "good" sign (if anything with such a disease can be considered good).
I just don't see why your doctors would say you have deletion 17p (a negative factor). The wording of your result seems to indicate that you have an extra gene 53p (on chromosome 17), which could indicate an extra chromosome 17, not a deletion. Then you have a smaller subclone with an extra TWO 53p genes, which could mean a total of 4 chromosome 17's in that subclone (3.2% of the tested cells). I think that is termed tetraploidy (four copies).
I can't help but wonder if that 3.2% sub-population is a further evolution of the larger clone (42% of the cells) that have the 2 extra ATM genes on chromosome 11 (4 signals, i.e., could be chromosome 11 tetraploidy) and one extra 53p (three signals).
I asked my Kaiser hematologist some very technical questions about my own FISH tests, and she said right out "I'm not an expert on FISH testing" and then referred me for a consult with the "transplant doctors" with City of Hope / Kaiser (maybe she would have referred me to them anyway, but she said to ask them my questions).
So from what you say, I'm just wondering if your two doctors are not experts in FISH either, and are overworked as may be typical at Kaiser, and just read your report to the extent they saw the mention of chromosome 17 abnormalities and jumped to the conclusion that meant 17p deletion - ?
I think in cases of 17p deletion, it would clearly state that only ONE signal was read. For instance, in my case I have the 13p deletion, and the report reads: "ONE signal for the RB1 gene using the RB1 prove in 32 of 250 cells analyzed (7.2%)".
In my case I was found to have an extra signal for FGFR3 on chromosome 4. My great concern was if this could be an ambiguous indicator of 4:14 translocation - but I was never able to get a better answer. One of the Beacon experts said to another patient that an extra chromosome 4 was a good rather than bad indicator.
I hope this is the case with you - that they are just misreading the fine print and that having an extra chromosome 17 (or 2) is just a case of hyperdiploidy that tends to put you in the "standard risk" category. I would definitely ask them how that wording on your result can mean 17p deletion.
From my recollection, you are a fellow Southern California Kaiser patient - Hi there! I've been reading your posts with great interest.
I was diagnosed with smoldering myeloma at Kaiser last September, after 4.5 years of MGUS. They ran the exact same set of FISH probes on me last fall and, as an aside, I was disappointed they did not run a probe to determine chromosome 1 copy number abnormalities, as it is a potential risk factor, or more probes to determine the possibility of hyperdiploidy, which is a "good" sign (if anything with such a disease can be considered good).
I just don't see why your doctors would say you have deletion 17p (a negative factor). The wording of your result seems to indicate that you have an extra gene 53p (on chromosome 17), which could indicate an extra chromosome 17, not a deletion. Then you have a smaller subclone with an extra TWO 53p genes, which could mean a total of 4 chromosome 17's in that subclone (3.2% of the tested cells). I think that is termed tetraploidy (four copies).
I can't help but wonder if that 3.2% sub-population is a further evolution of the larger clone (42% of the cells) that have the 2 extra ATM genes on chromosome 11 (4 signals, i.e., could be chromosome 11 tetraploidy) and one extra 53p (three signals).
I asked my Kaiser hematologist some very technical questions about my own FISH tests, and she said right out "I'm not an expert on FISH testing" and then referred me for a consult with the "transplant doctors" with City of Hope / Kaiser (maybe she would have referred me to them anyway, but she said to ask them my questions).
So from what you say, I'm just wondering if your two doctors are not experts in FISH either, and are overworked as may be typical at Kaiser, and just read your report to the extent they saw the mention of chromosome 17 abnormalities and jumped to the conclusion that meant 17p deletion - ?
I think in cases of 17p deletion, it would clearly state that only ONE signal was read. For instance, in my case I have the 13p deletion, and the report reads: "ONE signal for the RB1 gene using the RB1 prove in 32 of 250 cells analyzed (7.2%)".
In my case I was found to have an extra signal for FGFR3 on chromosome 4. My great concern was if this could be an ambiguous indicator of 4:14 translocation - but I was never able to get a better answer. One of the Beacon experts said to another patient that an extra chromosome 4 was a good rather than bad indicator.
I hope this is the case with you - that they are just misreading the fine print and that having an extra chromosome 17 (or 2) is just a case of hyperdiploidy that tends to put you in the "standard risk" category. I would definitely ask them how that wording on your result can mean 17p deletion.
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Carol of Eden - Name: Carol
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: MGUS 2009, SMM 2013
- Age at diagnosis: 50
Re: Does anybody here speak FISH? Can someone translate?
First, I want to emphasize that I am no expert on reading FISH results, and that this really should be verified by a pathologist. But I agree with the others that the report doesn't suggest a 17p deletion (again, I'm no expert, so please verify all this an MD).
The report was probably signed by the pathologist that did the analysis. I might suggest contacting that pathologist (he's probably at your hospital?) to discuss this report. I reached out to my original pathologist when I first got my report and found him to be very helpful.
My understanding is that a17p deletion is worrisome because this is where the TP53 gene is located. TP53 is an important gene for tumor regulation and is responsible for producing a very important protein known as p53, which is involved in managing gene mutations and apoptosis (cellular death). I believe there are also drug-treatment considerations that come into play if you have del 17p.
See:
http://en.wikipedia.org/wiki/P53
The report was probably signed by the pathologist that did the analysis. I might suggest contacting that pathologist (he's probably at your hospital?) to discuss this report. I reached out to my original pathologist when I first got my report and found him to be very helpful.
My understanding is that a17p deletion is worrisome because this is where the TP53 gene is located. TP53 is an important gene for tumor regulation and is responsible for producing a very important protein known as p53, which is involved in managing gene mutations and apoptosis (cellular death). I believe there are also drug-treatment considerations that come into play if you have del 17p.
See:
http://en.wikipedia.org/wiki/P53
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Does anybody here speak FISH? Can someone translate?
Your report's final sentence suggests hyperdiplodity, which means extra copies of chromosomes, hence standard risk or better.
If you had deletions they would use the term hypodiploid. I believe your doctors made the wrong call.
You should ask both of them to explain why they informed you that you had high risk features - ask them which data directed them to that label.
I wish you luck, that is very unsettling. Was your treatment regimen based upon this high risk label?
If you had deletions they would use the term hypodiploid. I believe your doctors made the wrong call.
You should ask both of them to explain why they informed you that you had high risk features - ask them which data directed them to that label.
I wish you luck, that is very unsettling. Was your treatment regimen based upon this high risk label?
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Wondering
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