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Clarification on Quantitative and qualitative PCR

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Hi people!

On March,15, after fews weeks feeling fever and nocturnal sweating, it was revealed a white blood count of 239 and hb 8,7. I started taken hydrea until March, 29 when the first qualitative PCR was available and showed the BCR-ABL fusion isoform b3a2-p210 confirming the CML diagnostic. I started taken Imatinibe 400 mg/day, since March, 30 and stopped Hydrea.

It was supposed to be made a quantitative PCR test 3 months after the starting treatment with Imatinibe. However, it was, wrongly, done a (second) qualitative RT-PCR on last June showing isoforms e1a2-p190 and b3a2-p210. Both tests were done in the same lab.

Is there any relevant info for the purpose of the treatment that it was dsicovered a second isoform in the second qualitative test?

I achieved CHR in 35 days after the Imatinibe dosage of 400 mg/day. The result of the quantitative PCR (p210 isoform), done in early July, showed a MR2 (2 log) reduction. The IS was 0,12305%, which is good. 

My second question is about the need for the quantitative PCR for the p190 isoform (if applicable). The quantitative PCR was done in another lab.

 

Regards, SIlas

My oncologists orders the p190 PCR every time I have the p210 test done.  I think it's overkill to do it every time, but I have to pick my battles and this is not one I care to wage.  My p190 test has always been negative.

Hi Silas,

My understanding is at diagnosis they only order checks for p210 which is the hallmark of CML. A coexistence is common for p210 and p190 and I believe the treatment and outcomes are the same. If you had p190 alone I believe the outcomes are less favourable as people with p190 alone don’t respond very well to TKI. I also understand those with sole p190 is extremely rare (1-2%) of all those in Chronic phase.

I hope that’s helpful.

All the best with your treatment.

Alex

I'll ask my oncologist to order on the next PCR on both isoforms p210 and p190. It seems the safest path. Thanks