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Hello all, just received a strange letter from my Doc and it's got me really really worried as I haven't a clue what this means ,it's says .    Unfortunately we have just had a report regarding you BCR/ ABL .They we're unable to obtain a result because the ABL value was below the accepted limit of 5,000 copies .This does not signify a concern with regards to what your CML is doing, for us to have an accurate reading ,we need to get a repeat sample.     Any thoughts please ,thank you ,Denise.

Hi Denise.

It's not a cause for concern at all. Let's get that out of the way first.

In order to test your blood with enough accuracy to test down to MR4.5 you need about 32,000 assays. Each assay is a little bit of genetic material that is checked for the existence of the BCR-Abl gene. If your PCR number was 0.1% and there were 100,000 assays then 1 in 1,000 of the assays would be BCR-Abl and the rest would be the control gene (usually Abl).

So in your case the test only produced a maximum of 5,000 assays. Maybe the blood wasn't stored properly, or got too hot, or for too long or something like that. It's environmental stuff and the lab that causes the lower assays - nothing to do with the actual blood as it's taken from the body.

So why is 5,000 not good enough? Well, it means there could be these two outcomes ... no BCR-Abl in that sample, and it's "undetectable", or if there was just 1 count of BCR-Abl the result would be 0.02%. So the test isn't very sensitive as there's no way to get a decent reading with any amount of sensitivity.

The "gold standard" is 100,000 assays. But > 32,000 is generally good enough. Less than that and the results can't be relied on as much, and down below 5,000 you really couldn't draw a conclusion. Even at 5,000 it's sketchy. So your doctor was absolutely right. Repeat test is the only thing to do.

David.

Hi David ,thank you so much for your explanation ,a lot of it has gone over my head,as I never get much information from my Doc , but you have sort of put my mind at rest .This test was done at the beginning of August only got the letter this morning .I don't know what my blood is doing since May as the lab actually lost the test I had done in June.Thank you again, Denise.

All it means is that the lab testing process fucked up. That's it. Seems it's not the first time!

As you say, the bit of anxiety this can cause is that you go a bit longer between test results. But at least you know that the letter itself isn't a cause for concern.

David.

Haha David ,my words exactly and a few more expletives.This is happening at a hospital which is supposed to be excellent with experts and not my local one ,very annoying .

had happened to me exactly the same thing! There is absolutely no reason to worry about!! For some reason your blood didn t stored properly so they couldn t do pcr... Nothing to worry about!