22nd of September (22/09) is World CML Day- and we at CMLSgroup are taking the opportunity to launch a project that we have been working on for some time. It is a small educational booklet (a Primer) aimed at patients who want to know more about the how, the why and the wherefore of q-PCR testing. This project was embarked upon over 18 months ago, initially from and idea by Chris- one of our very supportive members- as an attempt to 'get to grips' with the confusion around PCR testing in general and the International Scale in particular.
The project grew to be rather larger that we had envisioned and it has taken some time to ensure we understood the complexities surrounding molecular testing, as well as the CML biology and genetics involved.
Needless to say this has been a challenge as the subject is quite complex to the lay person, but we have had the support of both UK and International CML expert clinicians and molecular biologists, so for those of you who believe that self-education can be very good medicine I am sure you will agree the final result been worth the effort.
We have printed hard copies which we will share with UK patients free of charge. All you need to do is pay for post and packing which is approximately £1.50 -£2 each.
If you would like a copy sent to you by post then contact me at cmlsupportgroup@gmail.com with your contact details postal address and how many copies you would like. I will then let you know then how much the P&P will be and when you should expect a copy.
I will collect orders and post them out by every 2 weeks or so.
For those outside the UK a PDF is available for free download.
I hope you will find it useful,
Sandy
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QRT-PCR
Quantitative Reverse Transcription Polymerase Chain Reaction : A primer for patients
Contents:
1. Background
*Introduction
'This booklet provides an overview of the quantitative Reverse Transcriptase Polymerase Chain Reaction (qRT-PCR) test. It includes a description of the qRT-PCR International Standardisation (IS) project within the context of the recently updated (2013) ELNet Recommendations and NCCN Treatment Guidelines for the treatment and management of Ph+CML based on molecular testing by qRT-PCR IS.
This primer provides a useful resource for patients and others with an interest in this important topic and will contribute to the better understanding and interpretation of qRT-PCR results and response to treatment. For simplicity the test is referred to as q-PCR throughout.
We hope this primer also serves as an exemplar in a healthcare environment where patients face a lifetime on therapy, enabling an in depth understanding, not just of the disease and its current treatments, including those in development, but also test methodologies used to monitor responses to therapy.
This primer has been developed following a suggestion from patient self-educators as a way to encourage a better understanding of q-PCR testing. The draft was further developed by Sandy Craine who is the author of the text on behalf of the CML Support Group.'
*Inside the cell
*Chronic Myeloid Leukaemia and the Philadelphia Chromosome
*Genetic Tests used at diagnosis and in the first months of TKI therapy
2. Quantitative Reverse Transcriptase Polymerase Chain Reaction (qRT-PCR)
*What the test measures and its relationship to other tests
*The BCR-ABL1 gene and its constituent mRNA, the protein tyrosine kinase Bcr-Abl1
*How the qRT-PCR test works in practice
*Factors affecting the suitability of a sample sent for testing
3. Response to treatment: the role of qRT-PCR testing
*Levels of Molecular Response
*Why results may differ between testing laboratories
4. The International Standardisation Project (IS)
*Establishing an international standard
*The foundation of the IS method
*Conversion Factor: How a specific local lab value is calculated to allow for conversion to the IS
*The International Standard: its usefulness as a prognostic tool
*Four key variables necessary for optimal qRT-PCR testing
*Switching between testing laboratories
5. Summary
6. Ensuring an optimal response to TKI therapy
*Adherence, the importance of taking daily therapy
*Drug resistant mutations
7. The Future
*New and Advanced Monitoring: q-PCR techniques; can we do better?
*Then and now: the post imatinib era
8. Glossary
9. Citations
10. References and useful links
11. CML Support Group
