Hi my husband was diagnosed with multiple myeloma in September. He has kidney failure and is in Stage 3. He is 52 years old. We are worried because he keeps dropping his hemoglobin and has to get blood transfusions.
His FISH results came back today:
FISH analysis of isolated plasma cells (CD138+ fraction) showed the following abnormalities:
4 copies of the ATM (11q22.3) and CCND1 (11q13) loci in 99% and 3 copies of the TCF3 locus (19p13.3) in 81%. No evidence of CCND1/IGH fusion or FGFR3/IGH fusion by interphase FISH.
These findings are consistent with the presence of an abnormal hyperdiploid clone with 4 copies of chromosome 11/11q and trisomy 19, as observed by concurrent chromosome analysis (CG15-3199). Correlation with other laboratory and clinical information is recommended.
nuc ish(ATMx4,TP53x2)[99/100],(D12Z1,D13S319,LAMP1)x2[97]
nuc ish(CCND1x4,IGHx2)[99/100]
nuc ish(FGFR3,IGH)x2[100]
nuc ish(PBX1x2,TCF3x3)[81/100]
Summary Table:
Locus Result
TP53 (17p13.1) within normal limits
ATM (11q22.3) 99% with 4 copies
del(13q) within normal limits
monosomy 13 within normal limits
CCND1 (11q13) 99% with 4 copies
PBX1 (1q23) within normal limits
TCF3 (19p13.3) 81% with 3 copies
IGH rearrangement No evidence of t(11;14) or t(4;14)
I don't understand the results and am scared. Can anyone help me?
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Re: Meaning of my husband's FISH results?
CLW,
Welcome to the forum. I'm sorry to hear about your husband's situation.
Is he currently receiving multiple myeloma treatment? If so, what drug combination off multiple myeloma drugs is he receiving?
Is he under the care of a top multiple myeloma specialist (not just an oncologist/hematologist that may have some familiarity with multiple myeloma)? If you are not sure, folks on this forum can make some recommendations as to where to find these specialists if you let us know what city you are in. I can't stress enough how important it is to being working with a top multiple myeloma specialist in your husband's situation.
FISH test results are notoriously difficult for a layman to interpret. But at first glance, it doesn't appear to me that he has any of the really worrisome genetic mutations that represent high-risk multiple myeloma (TP53 deletions and/or IGH translocations). But only your doctor can confirm this and I am by no means qualified to offer any sort of a trustworthy interpretation of these test results.
Welcome to the forum. I'm sorry to hear about your husband's situation.
Is he currently receiving multiple myeloma treatment? If so, what drug combination off multiple myeloma drugs is he receiving?
Is he under the care of a top multiple myeloma specialist (not just an oncologist/hematologist that may have some familiarity with multiple myeloma)? If you are not sure, folks on this forum can make some recommendations as to where to find these specialists if you let us know what city you are in. I can't stress enough how important it is to being working with a top multiple myeloma specialist in your husband's situation.
FISH test results are notoriously difficult for a layman to interpret. But at first glance, it doesn't appear to me that he has any of the really worrisome genetic mutations that represent high-risk multiple myeloma (TP53 deletions and/or IGH translocations). But only your doctor can confirm this and I am by no means qualified to offer any sort of a trustworthy interpretation of these test results.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Meaning of my husband's FISH results?
Hello clw1028,
I cannot speak to the FISH results, but what I can relate to is the "we are scared" comment.
My husband was diagnosed with multiple myeloma earlier this month. I understand how you feel, and wish your husband all the best. I got a grip on my husband's diagnosis by reading this forum and going to the various articles that are referenced here, and other places.
They have come a long way with multiple myeloma over the years and have very successful treatments, and more are on the way.
Stay positive, stay informed, and stay strong. Not always easy to accomplish, I know. We don't always get to choose the path we walk, but we can master the path given us!
T
I cannot speak to the FISH results, but what I can relate to is the "we are scared" comment.
My husband was diagnosed with multiple myeloma earlier this month. I understand how you feel, and wish your husband all the best. I got a grip on my husband's diagnosis by reading this forum and going to the various articles that are referenced here, and other places.
They have come a long way with multiple myeloma over the years and have very successful treatments, and more are on the way.
Stay positive, stay informed, and stay strong. Not always easy to accomplish, I know. We don't always get to choose the path we walk, but we can master the path given us!
T
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T-wife - Name: T-wife
- Who do you know with myeloma?: My husband
- When were you/they diagnosed?: October 2015
- Age at diagnosis: 68
Re: Meaning of my husband's FISH results?
T-Wife wrote:
Thank you, T. I'm going to make this a stickie on my screen. We go to the oncologist in 3 hours to get a diagnosis from all the testing.
-Wendy
We don't always get to choose the path we walk, but we can master the path given us!
Thank you, T. I'm going to make this a stickie on my screen. We go to the oncologist in 3 hours to get a diagnosis from all the testing.
-Wendy
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wekebu - Name: Wendy
- Who do you know with myeloma?: Hubby
- When were you/they diagnosed?: Jan 2016
- Age at diagnosis: 55
Re: Meaning of my husband's FISH results?
Hi Multibilly,
Related to your comment on the FISH test, the TP53 test says "within normal limits," but it does not say negative.
So if the test comes undetected, does it mean the high-risk trait is negative?
We had a FISH test once, where TP53 was detected. But the second test, just before ASCT, the test came out undetected. (Which brings another topic of mutation... but let's not go there...)
Does the number of these clones have any connections woth the prognosis?
Thanks. TPT
Related to your comment on the FISH test, the TP53 test says "within normal limits," but it does not say negative.
So if the test comes undetected, does it mean the high-risk trait is negative?
We had a FISH test once, where TP53 was detected. But the second test, just before ASCT, the test came out undetected. (Which brings another topic of mutation... but let's not go there...)
Does the number of these clones have any connections woth the prognosis?
Thanks. TPT
Re: Meaning of my husband's FISH results?
Generally, we all have a wide variety of genetic mutations and will continue to develop new mutations over time. But thankfully, damaged genes such as TP53 can be repaired and/or eliminated by various mechanisms in one's body. It's when there is an excessive amount of a given mutation and when the various repair mechanisms in one's body start to fail for a given gene(s) that causes doctors and patients to worry and cancer comes into play.
Additionally, when one gets a FISH test, the results can vary simply depending on the location of the test (that is, you could have two different sets of FISH results from two biopsy samples taken at that same time). In other words, one biopsy could detect no TP53 anomalies, but the other test performed at the same time, but an inch away from the first biopsy, could detect the presence of TP53 anomalies.
So, I believe your doc would say not to worry about any given FISH finding as long as its within the normal limits for that given mutation. But you should really check with your doc regarding this.
Additionally, when one gets a FISH test, the results can vary simply depending on the location of the test (that is, you could have two different sets of FISH results from two biopsy samples taken at that same time). In other words, one biopsy could detect no TP53 anomalies, but the other test performed at the same time, but an inch away from the first biopsy, could detect the presence of TP53 anomalies.
So, I believe your doc would say not to worry about any given FISH finding as long as its within the normal limits for that given mutation. But you should really check with your doc regarding this.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
6 posts
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