Last week, my oncologist, who has been very encouraged by the good numbers achieved with my treatment began last February, told me that I am now in "hematologic" (or "hematological") remission. It wasn't until I got back home that I realized I didn't understand the distinction between "hematologic remission" and "full remission".
Can anyone clarify the terminology for me?
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dbrr - Name: Michael
- Who do you know with myeloma?: self and my stepmother
- When were you/they diagnosed?: 3/22/17
- Age at diagnosis: 67
Re: What is "hematologic remission" in multiple myeloma?
Hi Michael,
When you look at the results of your lab tests to get your M-spike and free light chain values, you are looking at indirect byproducts of the actual myeloma cancer cells themselves. A hematological complete response in myeloma is one where no indirect products such as monoclonal heavy chains (M-spikes) or monoclonal free light chains are showing up via immunofixation and you have less than 5% plasma cells in your bone marrow. I suppose that your doctor may have called a "hematological complete response" a "hematological remission", but you should really verify that with your doctor.
But keep in mind that a hematological complete response does not actually include any criteria for measuring the number of myeloma cells themselves. For that, you need iFISH tests in addition to advanced flow cytometry and / or genetic sequencing tests to directly measure your myeloma cells in your system. When you include the direct measurement of the myeloma cells themselves as part of the response criteria, this is known as a molecular response as opposed to a hematological response.
When you look at the results of your lab tests to get your M-spike and free light chain values, you are looking at indirect byproducts of the actual myeloma cancer cells themselves. A hematological complete response in myeloma is one where no indirect products such as monoclonal heavy chains (M-spikes) or monoclonal free light chains are showing up via immunofixation and you have less than 5% plasma cells in your bone marrow. I suppose that your doctor may have called a "hematological complete response" a "hematological remission", but you should really verify that with your doctor.
But keep in mind that a hematological complete response does not actually include any criteria for measuring the number of myeloma cells themselves. For that, you need iFISH tests in addition to advanced flow cytometry and / or genetic sequencing tests to directly measure your myeloma cells in your system. When you include the direct measurement of the myeloma cells themselves as part of the response criteria, this is known as a molecular response as opposed to a hematological response.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: What is "hematologic remission" in multiple myeloma?
Multibilly is of course right, but semantics are often confusing, especially when it comes to multiple myeloma. For example, I have a "serologic" relapse, which means my M-spike has trended higher, but not a "clinical" relapse, which means I have no active CRAB features.
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coachhoke - Name: coachhoke
- When were you/they diagnosed?: Apri 2012
- Age at diagnosis: 71
Re: What is "hematologic remission" in multiple myeloma?
If no bone marrow biopsy was performed after treatment, then all the doctor can do is describe the situation based on the blood work. The percent plasma cells is unknown at this point. Assuming, of course, no other symptoms are present.
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Foundry738 - Name: Biclonal
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 2016
- Age at diagnosis: 67
Re: What is "hematologic remission" in multiple myeloma?
Many thanks for your thoughtful responses. I have been traveling a bit, hence my late reply. By the time I return, it will have been eight weeks without a visit to oncology. The next set of bloods will undoubtedly include light chains as well as all the more common ones. I suppose that long without a treatment (Darzalex is still supposed to be administered every other week) might cause the numbers to go in the wrong direction.
Whether this schedule disruption will be shown to be a good long-term choice or not, I am really enjoying improved energy levels without any infusions. Still tired much of the time, but some days can be gotten through without any naps. I had given up any hope.
Whether this schedule disruption will be shown to be a good long-term choice or not, I am really enjoying improved energy levels without any infusions. Still tired much of the time, but some days can be gotten through without any naps. I had given up any hope.
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dbrr - Name: Michael
- Who do you know with myeloma?: self and my stepmother
- When were you/they diagnosed?: 3/22/17
- Age at diagnosis: 67
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