New Testing for Chronic Lymphocytic Leukemia and Multiple Myeloma Patients
According to George Hollenberg, a leading NY-area pathologist and founder of Acupath Laboratories, Over the past decade, advances in cytogenetics testing have propelled researchers to an entirely new level of understanding where many cancers are concerned. Yet, even such an intricate testing process as conventional cytogenetics can have its limits, and scientists have found those limits in cytogenetics testing for two cancers in particular: Chronic Lymphocytic Leukemia (CLL) and Multiple Myeloma (MM). The good news is that another testing process called I-FISH (Interphase Fluorescence In-Situ Hybridization, aka Molecular Cytogenetics) can augment conventional cytogenetics testing in cases of CLL and MM, providing doctors and patients with significant missing data that can lead to more accurate diagnosis, prognosis and treatment decisions.
Plainview, NY (PRWEB) June 29, 2006
Over the past decade, advances in cytogenetics testing have propelled researchers to an entirely new level of understanding where many cancers are concerned. Yet, even such an intricate testing process as conventional cytogenetics can have its limits, and scientists have found those limits in cytogenetics testing for two cancers in particular: Chronic Lymphocytic Leukemia (CLL) and Multiple Myeloma (MM). The good news is that another testing process called I-FISH (Interphase Fluorescence In-Situ Hybridization, aka Molecular Cytogenetics) can augment conventional cytogenetics testing in cases of CLL and MM, providing doctors and patients with significant missing data that can lead to more accurate diagnosis, prognosis and treatment decisions.
“Conventional cytogenetic testing was a critical research breakthrough in the last 20-30 years, as it allowed the medical community to associate specific chromosome abnormalities (additions, deletions or translocations) with specific types of cancer,” explains Dr. George Hollenberg, M. D., a leading NY-area pathologist and founder of Acupath Laboratories. “From there, scientists have designed targeted treatments for chronic myelogenous leukemia (CML) breast cancer, bladder cancer, and other leukemias and cancers.” Dr. Hollenberg notes that the limitations of conventional cytogenetics testing for CLL and MM lie in the types and numbers of cells that can be analyzed using the process, as well as the mode of study itself.
MM and CLL are both hematological cancers involving B-cells, a type of white blood cell or lymphocyte. In CLL, the cells are located primarily in the bloodstream, while in MM they are located mostly in bone marrow. As these malignant cells begin to proliferate, they crowd out normal blood production and often affect other healthy tissue and bone growth. While CLL usually progresses slowly and produces few symptoms in its early stages, MM is more aggressive and can have serious adverse effects on patient quality of life. The National Cancer Institute estimates that CLL is the most prevalent form of leukemia, with approximately 70,000 current cases in the U. S., while the American Cancer Society predicts 16,000 Americans will be diagnosed with Multiple Myeloma this year alone.
According to Dr. Hollenberg, the typical cytogenetic analysis, done using a light microscope, is completed on a total of 20 cells. “This testing can see a plethora of changes that may indicate that a certain cancer is present, has recurred, or is worsening. In Multiple Myeloma and Chronic Lymphocytic Leukemia, however, these tell-tale signs of development or advancement may elude detection due to the nature of the cancer cells,” he explains. “Also, significant sub-microscopic changes may occur which are below the level of detection by conventional cytogenetics.”
On the other hand, I-FISH targets certain chromosomal defects known to be associated with different prognoses and that may very likely be missed by cytogenetic testing. What’s more, the I-FISH test can detect sub-microscopic changes, and can study up to 500 cells at once, dwarfing the 20 or so that are studied in an average cytogenetics test. Although I-FISH provides much more sensitivity, it cannot take the place of traditional cytogenetics testing, because each I-FISH procedure can only detect those changes for which it was designed to find. Dr. Hollenberg explains, “If the doctor suspects a certain problem, we can select DNA “probes” to use in the I-FISH assay to check for that specific problem. However, I-FISH will not find a host of other possible issues during that specific analysis.”
So the key to the most comprehensive and accurate testing in cases of Multiple Myeloma and Chronic Lymphocytic Leukemia, according to Dr. Hollenberg, is twofold. “By combining traditional cytogenetics testing – which can detect at the microscopic level an array of chromosomal changes that indicate cancer development, recurrence or worsening – with I-FISH testing – which can identify certain changes that may not be seen by cytogenetics – we can give doctors and patients the information they need to make better decisions regarding treatment options and quality of life issues.
About Dr. George Hollenberg
Dr. George Hollenberg, M. D. is an authority in the fields of pathology, clinical pathology and dermatopathology with expertise in the areas of dysplastic nevi, melanoma, prostate and gastrointestinal cancer. Board-certified in Pathology and Dermatopathology, Dr. Hollenberg is a Fellow of the College of American Pathologists, The American Society of Dermatopathology and the AMA. He has published articles on skin, prostate and gastrointestinal cancer, and is the Consultant in Dermatopathology to The North Shore University Hospital Center. As the founding director of Acupath Laboratories, Inc., Dr. Hollenberg supervises the analysis of tens of thousands of biopsies per year, using the latest cutting-edge technology in histology and immunocytochemistry, as well as the latest advances in computerized report preparation.
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