Thank you very much, Multibilly, for your reply and reference that you posted from Dr. Voorhees:
I know that this is a moving target as test methodologies change not only over time, but also from center to center.
I gather from Dr. Voorhees' comment that the "staining" is potentially done on both the aspirate (subject to dilution) and the core sample (subject to patchiness). This actually confuses the situation a bit more. I guess you have to look at the wording of the report, and ask your doctor.
I guess an updated version of my question would be what exactly is the flow cytometry test as it relates to minimal residual disease evaluation – is it done on the aspirate or the marrow?
I have heard frequently that many patients and caregivers do not fret or worry over these questions, and just simply ask the doctor to interpret the info for them. As for me, I guess I am curious, and probably always will be.
Thank you again. Regards,
Forums
Re: Plasma cell & chromosomal abnormality percentages
Last edited by JPC on Tue Jun 07, 2016 9:21 am, edited 1 time in total.
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JPC - Name: JPC
Re: Plasma cell & chromosomal abnormality percentages
Hello,
Just to share a bit, in my case, they did say the percentages of plasma cell involvement but they did not write the FISH in terms of percentage because it could be misleading.
The FISH overall sample was only 200 nuclei in my case. So they selected good 200 cells and saw how many of those have abnormal mutations. Henceforth FISH test may even be more patchy compared to bone marrow biopsy. (FISH takes a few samples from the bone marrow biopsy. So if the bone marrow biopsy was dry or very little, or does not contain myeloma, then the FISH may not be accurate.)
Even more so is our case: we had 2 FISH tests, the first one said that p53d was detected, while the second one said no p53d was detected (at all). Now, the conclusion was "no abnormal mutations was detected," but this does not mean that "we don't have p53d." The doctor was surprised by the tests (as they were done in the same labs over 1-year period), but he still treated Dad as a high-risk myeloma patient.
Though on the side note, there have been cases of mutation from p53d to non-p53d. Oh well, at least Dad is 5-6 years into myeloma and he is still in remission. This is what's important -- there's still hope for high-risk patients.
Best of luck to all of you, may God bless us all.
Tpt
Just to share a bit, in my case, they did say the percentages of plasma cell involvement but they did not write the FISH in terms of percentage because it could be misleading.
The FISH overall sample was only 200 nuclei in my case. So they selected good 200 cells and saw how many of those have abnormal mutations. Henceforth FISH test may even be more patchy compared to bone marrow biopsy. (FISH takes a few samples from the bone marrow biopsy. So if the bone marrow biopsy was dry or very little, or does not contain myeloma, then the FISH may not be accurate.)
Even more so is our case: we had 2 FISH tests, the first one said that p53d was detected, while the second one said no p53d was detected (at all). Now, the conclusion was "no abnormal mutations was detected," but this does not mean that "we don't have p53d." The doctor was surprised by the tests (as they were done in the same labs over 1-year period), but he still treated Dad as a high-risk myeloma patient.
Though on the side note, there have been cases of mutation from p53d to non-p53d. Oh well, at least Dad is 5-6 years into myeloma and he is still in remission. This is what's important -- there's still hope for high-risk patients.
Best of luck to all of you, may God bless us all.
Tpt
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