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I don’t know if I’m mutated or unmutated??? Will I ever know?

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Ask the Lab Scientist Question:

Diagnosed in April 2021 and I will see my CLL Specialist again in October. Can you explain why my lgvh mutation analysis from LabCorp states No Result? They said “A B‑cell band could not be detected; thus, no further sequencing analysis could be performed. This could be caused by low concentration of B-cell monoclonal population present in the submitted specimen. Failure to detect a B-cell clonal band could be caused by mutation occurring at the PCR primer binding regions that prevent effective amplification of the lgh sequence.”

If they aren’t B cells, then what are they? My WBC is 218,000.

A month prior, Neo Genomics Lab results for lgvh mutation states “Testing cannot be completed. Results of RT-PCR amplification of the lgvh gene variable region do not detect a monoclonal population of B-cells. Gel analysis of this sample shows a dominant clonal band in a background of one or more smaller papulation of B-cells. Sequencing analysis cannot be performed due to interference of multiple peaks of the present smaller B-cell population.”

I guess I don’t know if I’m mutated or unmutated??? Will I ever know?

Fish results: 77% of nuclei positive for Trisomy 12. All other Fish tests results were normal.

Diagnosed in routing blood test in April WBC 150,000.

In August WBC 218,000, Hgb 10.2 Plat.152. RBC 3.57.

Answer: Of much more importance is that you need to have a discussion with your oncologist to determine what type of malignant cells you do have. I am going to assume that you have not had any/sufficient treatment to drive the numbers of B cells to a significantly depleted state. At present, you do not have enough B cells to be able to be tested. One must have to suspect that it is possible for you to have an atypical presentation.