Hello all,
My husband was diagnosed in April 2015 with multiple myeloma; after induction and some maintenance, his SPEP/IFX has now come back with no measurable serum monoclonal protein. We are ecstatic with these results and very grateful.
My question has to do with whether he has achieved a complete response (CR) or stringent complete response (sCR). Does he need to have a bone marrow biopsy to characterize his response to treatment or is that unnecessary?
When is a bone marrow biopsy indicated? (Obviously he had one for diagnosis in April).
I would appreciate your shared experiences on when another bone marrow biopsy is indicated.
Thank you all!
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lwem - Name: Laurie
- Who do you know with myeloma?: husband
- When were you/they diagnosed?: April 2015
- Age at diagnosis: 68
Re: Bone marrow biopsy and response to treatment
Hello, Laurie:
Congratulations on reaching the CR for your husband. There is recent indicator that is being phased in over the last year or so, which is testing for minimal residual disease. That looks at the marrow and aspirate for signs of individual cells.
If you are MRD-, that does not mean you are "cured", at this stage. If you are MRD+, however, it could suggest additional treatments may be in order to drive the multiple myeloma down some more, to extend the period of remission.
MRD testing does require a bone marrow biopsy at this stage (maybe a couple of years down the road it might be a blood test). So that might be a reason that you might want a BMB.
Good luck and Regards,
Congratulations on reaching the CR for your husband. There is recent indicator that is being phased in over the last year or so, which is testing for minimal residual disease. That looks at the marrow and aspirate for signs of individual cells.
If you are MRD-, that does not mean you are "cured", at this stage. If you are MRD+, however, it could suggest additional treatments may be in order to drive the multiple myeloma down some more, to extend the period of remission.
MRD testing does require a bone marrow biopsy at this stage (maybe a couple of years down the road it might be a blood test). So that might be a reason that you might want a BMB.
Good luck and Regards,
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JPC - Name: JPC
Re: Bone marrow biopsy and response to treatment
The criteria for sCR are normal immunofixation and electrophoresis, normalization of light chains and ratio, less than 5% plasma cells on a bone marrow biopsy, and no evidence of new lesions or increased activity ona any existing lesions on imaging studies. Sorry, but you do need to have the bone marrow in order to "prove" sCR.
I hope you get to a sCR. Disappearance of an M-spike is a great start!
Happy new year!!!
I hope you get to a sCR. Disappearance of an M-spike is a great start!
Happy new year!!!
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