Hi FingersCrossed,
Is it easy for you to copy and paste the actual text of your entire FISH report? I suspect there is wording in it that makes it clear whether the sample was purified or not.
Sorry if you've already done this someplace else. I checked but it doesn't seem that you have, but I could have missed something.
Forums
Re: Percentages in FISH test results - significance?
Hi JimNY,
I don't have my report handy, but I can do it tomorrow. I've read it a few times and I don't see any mention of purifying and isolating, just that the analysis was done on 200 cells.
I could be missing something, so I'll pull in the text tomorrow.
I don't have my report handy, but I can do it tomorrow. I've read it a few times and I don't see any mention of purifying and isolating, just that the analysis was done on 200 cells.
I could be missing something, so I'll pull in the text tomorrow.
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FingersCrossed - Name: FingersCrossed
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Oct 2014 (Smoldering)
- Age at diagnosis: 44
Re: Percentages in FISH test results - significance?
Here is the text portion of my FISH report. I don't see where there is evidence that the cells were isolated and purified.
Fluorescence in situ hybridization (FISH)* with a panel of probes (Cytocell, Abbott) specific for detection of recurring chromosome abnormalities in MDS and plasma cell myeloma was performed on uncultured bone marrow cells. The regions/loci represented in these probe mixes for MDS detect copy number and deletion of chromosomes 5,7, and 20, copy number of chromosome 8, and rearrangement / deletion of EVI1 at 3q26.2 and FOXO1 at 13q14. The regions/loci represented in these probes for plasma cell myeloma detect copy numbers of 1p and 1q, copy numbers of chromosomes 3, and 9, t(11;14) [BCL1/IGH], copy number of chromosome 17 (CEP17) and p53 at 17p11.3, deletion / loss of chromosome 13, and rearrangement of IGH at 14q32. For each probe 200 cells were analyzed. FISH analysis demonstrated an abnormal hyperdiploid clone with extra copy of chromosomes 3,5,7,9,11,20, and monosomy 17 in 5-10% of the cells analyzed. Clinical and pathological correlation is recommended.
The cutoff values for trisomy is 1%, monosomy or deletion 2-4%, and for breakapart it is 2%. Efficiency of the probes is good.
Translation anyone?
I did find this blurb on the web site of the company that did the FISH analysis:
*Fluorescent In-Situ Hybridization/In-Situ Hybridization – We offer a comprehensive menu of probes and panels. [ company name ] utilizes cell enrichment techniques for plasma cell disorders to isolate these hard to find cells. Should you need additional information about our available FISH probes and panels, please contact our client service department for immediate assistance.
Fluorescence in situ hybridization (FISH)* with a panel of probes (Cytocell, Abbott) specific for detection of recurring chromosome abnormalities in MDS and plasma cell myeloma was performed on uncultured bone marrow cells. The regions/loci represented in these probe mixes for MDS detect copy number and deletion of chromosomes 5,7, and 20, copy number of chromosome 8, and rearrangement / deletion of EVI1 at 3q26.2 and FOXO1 at 13q14. The regions/loci represented in these probes for plasma cell myeloma detect copy numbers of 1p and 1q, copy numbers of chromosomes 3, and 9, t(11;14) [BCL1/IGH], copy number of chromosome 17 (CEP17) and p53 at 17p11.3, deletion / loss of chromosome 13, and rearrangement of IGH at 14q32. For each probe 200 cells were analyzed. FISH analysis demonstrated an abnormal hyperdiploid clone with extra copy of chromosomes 3,5,7,9,11,20, and monosomy 17 in 5-10% of the cells analyzed. Clinical and pathological correlation is recommended.
The cutoff values for trisomy is 1%, monosomy or deletion 2-4%, and for breakapart it is 2%. Efficiency of the probes is good.
Translation anyone?
I did find this blurb on the web site of the company that did the FISH analysis:
*Fluorescent In-Situ Hybridization/In-Situ Hybridization – We offer a comprehensive menu of probes and panels. [ company name ] utilizes cell enrichment techniques for plasma cell disorders to isolate these hard to find cells. Should you need additional information about our available FISH probes and panels, please contact our client service department for immediate assistance.
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FingersCrossed - Name: FingersCrossed
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Oct 2014 (Smoldering)
- Age at diagnosis: 44
Re: Percentages in FISH test results - significance?
Hi Fingers Crossed,
The report suggests that the plasma cells were NOT isolated since
As Dr. Voorhees suggested, the interpretation of your report is challenging in the absence of purified plasma cells.
As per the International Myeloma Working Group Guidelines on risk stratification*
"FISH data should be reported specifically for clonal plasma cells determined by surface marker or cytoplasmic immunoglobulin light chain expression, and not all cells. The positivity is to be determined by the percentage of positive cells that are above the individual laboratories' standard.
No specific global cutoff should be applied. It is unclear whether the number of positive cells carries any different risk. For example, if a patient has 7% versus 57% cells positive for a specific FISH abnormality, the relative risk for both patients is considered the same at present. This is not true for del(17p). In a report, del(17p) is prognostic only if present in at least 60% of the plasma cells.2"
However, given the blurb, you may try to contact the company to get more info.
*Reference: NC Munshi et al, "Consensus recommendations for risk stratification in multiple myeloma: report of the International Myeloma Workshop Consensus Panel 2," Blood, May 5, 2011 (full text)
The report suggests that the plasma cells were NOT isolated since
- There is no mention of "isolating/purifying plasma cells" or "CD-138/38 selection", and
- They used MDS probes (which would be directed at a different set of white cells) in the same sample.
As Dr. Voorhees suggested, the interpretation of your report is challenging in the absence of purified plasma cells.
As per the International Myeloma Working Group Guidelines on risk stratification*
"FISH data should be reported specifically for clonal plasma cells determined by surface marker or cytoplasmic immunoglobulin light chain expression, and not all cells. The positivity is to be determined by the percentage of positive cells that are above the individual laboratories' standard.
No specific global cutoff should be applied. It is unclear whether the number of positive cells carries any different risk. For example, if a patient has 7% versus 57% cells positive for a specific FISH abnormality, the relative risk for both patients is considered the same at present. This is not true for del(17p). In a report, del(17p) is prognostic only if present in at least 60% of the plasma cells.2"
However, given the blurb, you may try to contact the company to get more info.
*Reference: NC Munshi et al, "Consensus recommendations for risk stratification in multiple myeloma: report of the International Myeloma Workshop Consensus Panel 2," Blood, May 5, 2011 (full text)
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Dr. Heather Landau - Name: Heather Landau, M.D.
Beacon Medical Advisor
Re: Percentages in FISH test results - significance?
Thanks, Dr. Landau,
I actually did call the company, but no one returned my call. I'll try again or just wait until I meet with the specialist.
I actually did call the company, but no one returned my call. I'll try again or just wait until I meet with the specialist.
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FingersCrossed - Name: FingersCrossed
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Oct 2014 (Smoldering)
- Age at diagnosis: 44
Re: Percentages in FISH test results - significance?
Thanks, Dr. Landau. Your posting also clarified my question. The article you quoted from said:
"The positivity is to be determined by the percentage of positive cells that are above the individual laboratories' standard."
So, basically, if the percentage of plasma cells that test positive for a certain abnormality are above the margin of error for the test ("the individual laboratories' standard"), then a patient is said to have that chromosomal abnormality.
That's useful to know.
"The positivity is to be determined by the percentage of positive cells that are above the individual laboratories' standard."
So, basically, if the percentage of plasma cells that test positive for a certain abnormality are above the margin of error for the test ("the individual laboratories' standard"), then a patient is said to have that chromosomal abnormality.
That's useful to know.
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Jonah
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