What is a FISH blood test?

[mphillif]

I have just been diagnosed last week with CLL. My doctor ordered a FISH blood test. What is this for?

[AussieNeil Administrator]

It provides prognostic information that can help categorise where you fall with the degree of risk from your CLL and importantly, what treatments will work best should you need treatment. More here:

healthunlocked.com/cllsuppo...

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The FISH Panel (Fluorescence In Situ Hybridization) checks 4 specific chromosomes know to cause CLL, and looks for deletion of genetic data, or in the case of Trisomy 12 an extra chromosome.

It will come back showing 11q deletion, Trisomy 12, 13Q deletion or 17p deletion (or even combinations). It can also come back "Fish Normal" which does not mean you don't have CLL...just not from the known causes. Going from best to worst is 13Q, T12, 11q 17p. Fish normal can be anywhere on that scale.

Just because you have "bad" markers does not mean the end is near. I know several people with bad markers who have gone without treatment for more than a decade and others with only good markers who needed treatment after a couple years.

It does allow more information on what treatments might work best...regular old 13Q is FCR....17p, skip the FCR and use Ibrutinib sort of thing.

Scott

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Oh, I forgot to tell you, welcome to our little club. Take a breath, relax a little....you probably will not see much change in your life for years or even a decade or more. You have time to learn.

This web site is a fantastic place to come and get questions answered or just whine and moan about how horrible things are.

Scott

[baq724]

You’ll also want to ask about getting an IgVH mutational test. This will also help guide doctors in what treatment is best (if needed) and indicates how your cll might behave. Mutated is good. Markers that line up with mutational status are being CD38 negative <30%. And Zap 70 negative <20%. These correlate with about 70-75% accuracy in relation to mutational status. Usually being negative for both is a good indication of being mutated, but can only know with absolute certainty if you get the IgVH test which is expensive. My insurance wouldn’t pay for mine until I got in with a CLL specialist at MDA.

Unmutated patients should not do chemo treatments if other novel agent therapies are available. Remissions from FCR chemo for unmutated patients are short and novel agents like Ibrutinib are better for this population. (And maybe for all regardless of mutation status, but time will tell.)

[lankisterguy Volunteer]

AussieNeil and Scottxxoo have given excellent answers.

If you want to dig deeper there are 865 times that a similar question was asked. Some appear in a box labeled "Related Posts" (upper right column on a computer screen, way below on mobile devices).

Or you can read some of these: healthunlocked.com/search/f...

Len