This abstract linked below from ASH discusses MRD testing and PET/CT scans. When I first started reading it I thought that it was going to compare the two main types of MRD testing now is use with PET/CT scans to test which is the most reliable. It wasn't quite what I expected but it seems to suggest that a patient could be MRD negative but still have active lesions according to a PET/CT scan. I am not sure exactly what to make of it and am interesting in what others think is the import of the study.
https://myelomabeacon.org/resources/mtgs/ash2016/abs/377-2/
Forums
5 posts
• Page 1 of 1
Re: ASH Abstract re: MRD testing and PET/CT-scans
Hi!
To me it suggests that multiple myeloma is a patchy disease. A bone marrow sample could be free from monoclonal cells and the MRD tests would hence show no tumour burden. On the other hand PET scans can detect local active lesions. These lesions could be non secretory and will not show on MRD tests from a sample taken from another site.
Interesting though that continuous maintenance seems to push the response of treatment closer to or to MRD negativity.
// Mattias from Sweden
To me it suggests that multiple myeloma is a patchy disease. A bone marrow sample could be free from monoclonal cells and the MRD tests would hence show no tumour burden. On the other hand PET scans can detect local active lesions. These lesions could be non secretory and will not show on MRD tests from a sample taken from another site.
Interesting though that continuous maintenance seems to push the response of treatment closer to or to MRD negativity.
// Mattias from Sweden
-
Mattias - Name: Mattias
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Solitary plasmacytoma 2009. Myeloma 2013
- Age at diagnosis: 39
Re: ASH Abstract re: MRD testing and PET/CT-scans
Hi Andrew,
I guess I'm not surprised by this. There have been several cases on this forum where patients have been in serological remission with perfect bone marrow biopsy results, but then later developed new lytic lesions. Dr. Siegel described this pheonomenon well:
https://myelomabeacon.org/forum/relapse-with-low-m-spike-t430.html#p1659
I guess I'm not surprised by this. There have been several cases on this forum where patients have been in serological remission with perfect bone marrow biopsy results, but then later developed new lytic lesions. Dr. Siegel described this pheonomenon well:
https://myelomabeacon.org/forum/relapse-with-low-m-spike-t430.html#p1659
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: ASH Abstract re: MRD testing and PET/CT-scans
Hi all
I had a stem cell transplant in June, was told that I was in serological remission in September, and after Day 100 bone marrow biopsy was told I was MRD negative. Great, fantastic news, I can start to live a normal life (not) as 4 weeks later (November), I was told I had serologically relapsed, this time with an M-spike. I previously had free light chain disease.
As I relapsed 5 short months after transplant (took me this long to recover and during the process I lost the sight in my left eye), I am now classed as having aggressive disease, although my FISH studies showed only one abnormality which was not considered significant, i.e., not translocation t(4:14) or a deletion. I was not given maintenance therapy after day 100 as this is not routinely given in the UK. I did not have any kind of imaging to confirm MRD negative status (again not routinely given).
My thought process is how do the doctors know 100% that I had no evidence of disease when imaging was not carried out? As we know, myeloma is a patchy disease, what if my the bone marrow biopsy hit a benign spot and indeed there was disease elsewhere, imaging would have picked this up (hopefully) and therefore, I suspect I would have had consolidation / maintenance therapy and again hopefully I would not have relapsed so quickly. To be told you have aggressive disease because of limited response is frightening.
So now my options are to have auto/allo of to just take the drugs and hope for longer remissions!
Kind regards
I had a stem cell transplant in June, was told that I was in serological remission in September, and after Day 100 bone marrow biopsy was told I was MRD negative. Great, fantastic news, I can start to live a normal life (not) as 4 weeks later (November), I was told I had serologically relapsed, this time with an M-spike. I previously had free light chain disease.
As I relapsed 5 short months after transplant (took me this long to recover and during the process I lost the sight in my left eye), I am now classed as having aggressive disease, although my FISH studies showed only one abnormality which was not considered significant, i.e., not translocation t(4:14) or a deletion. I was not given maintenance therapy after day 100 as this is not routinely given in the UK. I did not have any kind of imaging to confirm MRD negative status (again not routinely given).
My thought process is how do the doctors know 100% that I had no evidence of disease when imaging was not carried out? As we know, myeloma is a patchy disease, what if my the bone marrow biopsy hit a benign spot and indeed there was disease elsewhere, imaging would have picked this up (hopefully) and therefore, I suspect I would have had consolidation / maintenance therapy and again hopefully I would not have relapsed so quickly. To be told you have aggressive disease because of limited response is frightening.
So now my options are to have auto/allo of to just take the drugs and hope for longer remissions!
Kind regards
-
SusanTR1964 - Name: Susan
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 8th February 2016
- Age at diagnosis: 51
Re: ASH Abstract re: MRD testing and PET/CT-scans
I agree with the posts above. You need to look at all of your tests in order to determine if you have had an excellent response to therapy. There is no test that is as accurate as time in knowing if you had a deep response to therapy.
-
Mark11
5 posts
• Page 1 of 1