[blair77]

Level of response - did my husband achieve a CR?

by blair77 on Fri Mar 14, 2014 11:13 pm

While my husband is treated at a Large Academic Hospital they do not have any doctors that are "myeloma" specialists on board. Following his transplant we were told he was in remission and did not need to move forward with a 2nd transplant. However, they never use the terms such as SCR, CR etc. as all the myeloma articles use? So I find it hard to compare his response to the articles written.

These are his results :

His diagnosis:
IgA lambda myeloma:

Post transplant results:

24 hour UPEP negative
Serum free light chains normal and sFLC ratio normal
SPEP at day 70 .1 BUT NEGATIVE immunifixation original monoclonal protein NOT DETECTED (trace IgM bands detected) A follow up SPEP 2 weeks later was m spike not detected
Bone marrow biopsy plasma cells less then 5% with NO CLONAL CELLS cytogenetics all normal
IgA levels normal IgG levels normal IgM levels normal

The doctor keeps saying this is as "good as it gets" with myeloma and "we know we can't cure it so the myeloma cells are there at a very low level they just can't be found on any of our tests."

However they never use the terms CR or SCR? From what I can tell this sounds like it is stringent complete response?

[Dr. Edward Libby]

Re: Level of response - did my husband achieve a CR?

by Dr. Edward Libby on Sat Mar 15, 2014 2:11 pm

Hello from gray and cool Seattle,

A stringent complete remission is "deeper" than a CR and is thought of as the best response than can be accomplished. There are other ways to look at response with techniques like polymerase chain reaction(PCR) that are not routinely available. The 2011 International Myeloma Working group definition of a stringent complete remission (sCR) is :

Negative immunofixation of serum and urine
Normal Free Light Chain ratio
Disappearance of any soft tissue plasmacytomas
Less than 5% plasma cells in the bone marrow
Absence of clonal PCs by immunohistochemistry or 2- to 4-color flow cytometry

This does sound like your husband has achieved a sCR.

Thank you for sharing your question with the Beacon !

[blair77]

Re: Level of response - did my husband achieve a CR?

by blair77 on Sat Mar 15, 2014 3:13 pm

Thanks for the detailed information!