Hi just a quick question about what is or is not considered a complete response.
I had a stem cell transplant about 2 years ago, for the last 18 months my M- Spike is 0 and freelight is normal. So I think this means I have CR?
I am in Canada and Bone Marrow Biopsies are not a regular part of monitoring response so not sure if there are any myeloma cells.
My blood work has never fully returned to normal. I have had elevated MCV (over 100) and low RBC's since transplant. Doc says this is normal after a transplant and not really Myeloma Per say.
Interested to hear what others think?
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Re: If u have irregularities in blood work, can u still be i
This forum thread from last year,
https://myelomabeacon.org/forum/complete-response-definition-t526.html
provides some information and links relevant to your question.
For example, according to the NCCN (the U.S. National Comprehensive Cancer Network, the definition of a complete response has three parts:
Disappearance of M-protein in the blood, less than 5 percent of plasma cells in the bone marrow, and no increase in size and number of bone lesions.
So you certainly have one key part of the complete response definition -- the disappearance of your m-protein. But, strictly speaking, it can't be determined whether you were in complete response because you don't have any bone marrow biopsy results.
As to the MCV and RBC values you mention, we'll have to rely on the experience of the patients who comment here on the board or the Beacon's Medical Advisors for their perspectives.
Good luck!
https://myelomabeacon.org/forum/complete-response-definition-t526.html
provides some information and links relevant to your question.
For example, according to the NCCN (the U.S. National Comprehensive Cancer Network, the definition of a complete response has three parts:
Disappearance of M-protein in the blood, less than 5 percent of plasma cells in the bone marrow, and no increase in size and number of bone lesions.
So you certainly have one key part of the complete response definition -- the disappearance of your m-protein. But, strictly speaking, it can't be determined whether you were in complete response because you don't have any bone marrow biopsy results.
As to the MCV and RBC values you mention, we'll have to rely on the experience of the patients who comment here on the board or the Beacon's Medical Advisors for their perspectives.
Good luck!
Re: If u have irregularities in blood work, can u still be i
In addition to having no measurable M-spike and a negative bone marrow, the current definition of CR also requires that another test, called immunofixation (or immunoelectrophoresis), is negative for any abnormal protein in the blood or urine. Sometimes the M-spike is unmeasurable, but the immunofixation still shows a faint abnormal protein -- this is called a near complete response (nCR). Even without these confirmatory tests, however, the fact that you're 2 years out from SCT without measurable M-spike and with a normal free light chain ratio is a great sign.
The MCV (mean corpuscular volume) is a measure of red cell production, and is often elevated after treatment with melphalan and other chemo agents. It's not unusual to have persistant mildly abnormal MCV and RBC counts post-SCT and is not necessarily related to the myeloma. If the numbers worsen over time, or if you become more significantly anemic, then a repeat bone marrow biopsy may be indicated to investigate further.
The MCV (mean corpuscular volume) is a measure of red cell production, and is often elevated after treatment with melphalan and other chemo agents. It's not unusual to have persistant mildly abnormal MCV and RBC counts post-SCT and is not necessarily related to the myeloma. If the numbers worsen over time, or if you become more significantly anemic, then a repeat bone marrow biopsy may be indicated to investigate further.
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Dr. Adam Cohen - Name: Adam D. Cohen, M.D.
Beacon Medical Advisor
Re: If u have irregularities in blood work, can u still be i
Thanks for all the info! I have had the immunofixation, I will check the results. I have a feeling it alternates with the freelight, so I get one or the other every two months along with M-spike before my check up.
I am feeling pretty good, back working etc. I do have some days where fatigue can get me, no doubt related to the mild anemia I have. I declined maintenence therapy post transplant, and I'm still ok with my decision, Living drug free at the moment and enjoying it.
(no side effects) It's a balance of watching / waiting, and being hopeful my multiple myeloma has been knocked way out into remission (and stays there!)
I am feeling pretty good, back working etc. I do have some days where fatigue can get me, no doubt related to the mild anemia I have. I declined maintenence therapy post transplant, and I'm still ok with my decision, Living drug free at the moment and enjoying it.
(no side effects) It's a balance of watching / waiting, and being hopeful my multiple myeloma has been knocked way out into remission (and stays there!)-
Anonymous
Re: If u have irregularities in blood work, can u still be i
One other note about the immunofixation. Some centers will first perform a serum protein electrophoresis (SPE or TPE), which is generally less expensive and generates results quicker than immunofixation (IFIX). Only if the SPE is negative for M-Protein, will they do the IFIX. I went for about seven months with SPE vacillating between 0.1 and 0, but the IFIX, which tends to be more sensitive and accurate, always came back with 0.1. Finally, after 11 cycles, both came back zero and have remained there for the past four months.
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Kevin J - Name: Kevin J
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: Jan 2011
- Age at diagnosis: 52
Re: If u have irregularities in blood work, can u still be i
Hi Kevin,
You are dead on about the difference in levels of sensitivity based on the test used.
Another example is
FLCA is sentistive as low as <img/l
whereas
SPEP only detects to the level as low as 1gm/l
You are dead on about the difference in levels of sensitivity based on the test used.
Another example is
FLCA is sentistive as low as <img/l
whereas
SPEP only detects to the level as low as 1gm/l
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suzierose - Name: suzierose
- When were you/they diagnosed?: 2 sept 2011
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