[johanna]

when to test for FISH ? on chemo already

by johanna on Sun Mar 03, 2013 9:19 am

I read all newly diagnosed patients could do cytogenetic test , Fish test... to establish wheather they are a high risk patient or not. also predict their responce to certain chemo drugs and high dose therapy (stem cell trans.)
my question is
if you`re already on chemo , can the drugs affect the results ? when is it the best time to do it ?

my friend Ian , is in cycle 7 (CTD) and heading toward SCT soon .
should we do genetic test now , or wait until chemo is over & recovered from stem cell ?

study_
``Deletions of p53 in multiple myeloma by interphase FISH. In 25 of 74
BM samples (33.8%) from patients with multiple myeloma, interphase FISH
analysis of plasma cells provided evidence for a p53 gene
deletion . Among 59 patients with newly diagnosed multiple myeloma,
a deletion of p53 was detected in 19 of them (32.8%); at relapse,
a p53 deletion was observed in 6 of 11 patients (54.5%).

None of the 4 patients studied during induction chemotherapy exhibited
a p53 deletion.
Two patients, who had normal findings for
p53 by FISH at diagnosis, were again studied at relapse, and a
deletion of p53 was detected in one of them``

[Nancy Shamanna]

Re: when to test for FISH ? on chemo already

by Nancy Shamanna on Sun Mar 03, 2013 11:10 am

Hi Johanna, From my reading, I think that it is good to get the FISH test before heading into any stem cell transplant (I had one done early on in my treatments). There are cytogenetic abnormalities which may cause a patient to be deemed 'high risk' that way, and which would make certain treatments counter-productive. To complicate matters, the nature of the disease is that one's cytogenetics may shift over the course of the disease, and from treatments too!
I am not a doctor, and this is only what I think I have learned , and hopefully one of the myeloma specialists will weigh in on this topic!

[Dr. Peter Voorhees]

Re: when to test for FISH ? on chemo already

by Dr. Peter Voorhees on Sun Mar 03, 2013 5:52 pm

The best time to do FISH testing and conventional cytogenetic testing is prior to therapy (e.g. at initial diagnosis and at relapse). If your friend has had a good response to treatment, and we most certainly hope he has!!, it may be hard to find cytogenetic abnormalities if the myeloma cells are far and few between. I would touch base with your friend to see if this was done at initial diagnosis. If it was not done and it is felt that there is enough disese left behind to get a reliable result, I would consider doing it now. It may help the decision making process regarding transplant and maintenance therapy. If your friend is in a complete remission or something close to it, it may not be valuable at this point.

Thanks!

Pete V.

[johanna]

Re: when to test for FISH ? on chemo already

by johanna on Tue Mar 05, 2013 5:19 pm

Dr. Pete V. and Nancy thank you both. you have been very helpful. doctors will consider another 2 cycles of chemo + 1 month break and stem cell.

Dr. Pete mentions "complete remission or something close to it";

What do physicians generally consider to be "something close" to complete remission?

many thanks

Ian had only BMA onc. said they can`t give a % of plasma cells.
the disease is focal and not diffuse
will a BMB give more information ar this point or in the future ?

[Dr. Edward Libby]

Re: when to test for FISH ? on chemo already

by Dr. Edward Libby on Fri Mar 08, 2013 2:47 pm

Hello from sunny Seattle,
Complete remission = disappearance of m-spike
"something close" = at least a 90% fall in the m-spike
Thanks

[johanna]

Re: when to test for FISH ? on chemo already

by johanna on Sat Mar 09, 2013 7:41 am

Dr. Libby , thank you very much for clearing up things . we will make sure to ask the doctor
what is the level of m-spike , and hopefully we can still do cytogenetic testing.