Hi Lisa,
The bone marrow tests are the ones you should focus your questions on. Here's what I'd ask:
What form of CML is it and was any mutation testing done?
Likely answer is P210, which is by far the most usual. Other types are P190 or P230. It's just the exact genetic arrangement. Mutation testing is not always done at diagnosis, but it might have been.
Was a FISH test performed on the marrow, and if so what was the result?
A FISH test looks at a sample (sometimes 20, sometimes 100) of marrow cells and checks each one to see if it has CML. The result will be 18/20 or 95/100 or something like that. Don't worry if it's 20/20 or 100/100 ... that's common.
Will I need another bone marrow test in the future?
Many clinics don't even do marrow tests at diagnosis any more, but some places do still want them at certain points.
When will my first PCR test be run?
Maybe it already has been. Mine was done at diagnosis. Unlike FISH tests on bone marrow, PCR tests are run on over a hundred thousand samples. They're very good at seeing tiny amounts of disease as your mum starts to respond to therapy.
How will I know imatinib is working? What are the treatment goals?
An "optimal" response would see a PCR score of 10% at 3 months. If your mum doesn't respond as quick as that, some doctors are quicker to switch to a different drug than others. Sometimes the tortoise wins the race, but sometimes switching is better.
You might also want to ask about the rest of your mum's blood counts, and how close they are to normal and if there are any to be concerned about at the moment (e.g. low platelets).
David
