Hi all,
Today, when we visited my mom's myeloma doctor for test results, we were presented with a new test that was done looking Minimal Residual Disease in Myeloma. This was a 8-color/parameter flow cytometric analysis of bone marrow cells.
I am wondering if anyone else has been getting these tests.
Thank you,
Alex
Forums
7 posts
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dnalex - Name: Alex N.
- Who do you know with myeloma?: mother
- When were you/they diagnosed?: 2007
- Age at diagnosis: 56
Re: Minimal Residual Disease
Hi Alex,
Tests for MRD have been used for a while in the context of allo transplants. My entire treatment plan is based around getting and maintaining MRD negative status. These tests are being used more in the non-allo setting now since more patients can achieve MRD status due to Velcade, Revlimid, etc. The 8 color flow cytometry may become the standard test for this in the future. It was first published by Doctors from Spain. If you are negative for MRD via flow cytometry they say you have attained an Immunophenotypic Respose. Hopefully your Mother attained MRD negative status. Here is an study from 2010 ASH showing patients that attain MRD negative status by flow cytometry having longer PFS than patients that do not attain it. If you Google Immunophenotypic and myeloma you will get a lot of information on this.
"In summary, this study demonstrates that the achievement of an IR is a strong prognostic factor regardless of the type of treatment; thus, higher IR rates may help to identify optimal therapeutical schemes. In this sense, HDT/ASCT is able to markedly increase IR rates after induction even in the era of novel agents, and this translates into extended survival."
https://ash.confex.com/ash/2010/webprogram/Paper32022.html
Best of luck to your Mother and your family moving forward.
Mark
Tests for MRD have been used for a while in the context of allo transplants. My entire treatment plan is based around getting and maintaining MRD negative status. These tests are being used more in the non-allo setting now since more patients can achieve MRD status due to Velcade, Revlimid, etc. The 8 color flow cytometry may become the standard test for this in the future. It was first published by Doctors from Spain. If you are negative for MRD via flow cytometry they say you have attained an Immunophenotypic Respose. Hopefully your Mother attained MRD negative status. Here is an study from 2010 ASH showing patients that attain MRD negative status by flow cytometry having longer PFS than patients that do not attain it. If you Google Immunophenotypic and myeloma you will get a lot of information on this.
"In summary, this study demonstrates that the achievement of an IR is a strong prognostic factor regardless of the type of treatment; thus, higher IR rates may help to identify optimal therapeutical schemes. In this sense, HDT/ASCT is able to markedly increase IR rates after induction even in the era of novel agents, and this translates into extended survival."
https://ash.confex.com/ash/2010/webprogram/Paper32022.html
Best of luck to your Mother and your family moving forward.
Mark
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Mark
Re: Minimal Residual Disease
Hi Mark,
Thank you very much for your fantastic answer. I appreciate it greatly.
I have been reading the scientific articles on minimal residual disease and myeloma, including the Spanish paper you referred to. It's very interesting. We will see what it means in the end. Even my mom's care providers admit that at this point, we don't quite know if it really means anything just yet.
Thank you for the well wishes!
Thank you very much for your fantastic answer. I appreciate it greatly.
I have been reading the scientific articles on minimal residual disease and myeloma, including the Spanish paper you referred to. It's very interesting. We will see what it means in the end. Even my mom's care providers admit that at this point, we don't quite know if it really means anything just yet.
Thank you for the well wishes!
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dnalex - Name: Alex N.
- Who do you know with myeloma?: mother
- When were you/they diagnosed?: 2007
- Age at diagnosis: 56
Re: Minimal Residual Disease
Dear dnalex,
I hope the fact that your Mom's physicians are testing for MRD means that she is in a complete remission by other measures!
MRD assessment by multiparametric flow cytometry is being increasingly used for assessment of MRD in multiple myeloma and is associated with more durable remissions. It is typically reserved for those patients who meet criteria for complete remission by other measures (SPEP/immunofixation). From a technical perspective, it is important that the sample being used to assess MRD is a pure bone marrow aspirate sample and not contaminated with excess peripheral blood. How this test is being used to effect treatment decisions remains a work in progress. For example, does a patient with lower risk myeloma and no MRD after stem cell transplant benefit from maintenance Revlimid therapy to the same degree as someone else? Future studies will increasingly use MRD as an endpoint for clinical efficacy and determine if additional consolidation therapy for those who do not achieve MRD is beneficial.
Best of luck to your Mom!
Pete V.
I hope the fact that your Mom's physicians are testing for MRD means that she is in a complete remission by other measures!
MRD assessment by multiparametric flow cytometry is being increasingly used for assessment of MRD in multiple myeloma and is associated with more durable remissions. It is typically reserved for those patients who meet criteria for complete remission by other measures (SPEP/immunofixation). From a technical perspective, it is important that the sample being used to assess MRD is a pure bone marrow aspirate sample and not contaminated with excess peripheral blood. How this test is being used to effect treatment decisions remains a work in progress. For example, does a patient with lower risk myeloma and no MRD after stem cell transplant benefit from maintenance Revlimid therapy to the same degree as someone else? Future studies will increasingly use MRD as an endpoint for clinical efficacy and determine if additional consolidation therapy for those who do not achieve MRD is beneficial.
Best of luck to your Mom!
Pete V.
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Dr. Peter Voorhees - Name: Peter Voorhees, M.D.
Beacon Medical Advisor
Re: Minimal Residual Disease
Dear Dr. Voorhees,
Thank you very much for your response and your kind wishes!
As you had surmised, my mom has been in complete remission for over two years. This was after her smoldering myeloma became active, and she underwent one autologous stem cell transplant. This was the first time MRD was tested, using BM cells.
I really hope that as studies progress, MRD will be as useful a tool for myeloma as in other blood cancers.
Alex
Thank you very much for your response and your kind wishes!
As you had surmised, my mom has been in complete remission for over two years. This was after her smoldering myeloma became active, and she underwent one autologous stem cell transplant. This was the first time MRD was tested, using BM cells.
I really hope that as studies progress, MRD will be as useful a tool for myeloma as in other blood cancers.
Alex
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dnalex - Name: Alex N.
- Who do you know with myeloma?: mother
- When were you/they diagnosed?: 2007
- Age at diagnosis: 56
Re: Minimal Residual Disease
Alex,
The MRD test is also done quite often in clinical studies. I had the test done after reaching sCR in the clinical study I was in with Carfilzomib, Revlimid, and Dexamethasone for newly diagnosed patients. As Mark indicated, if the tests come back negative (i.e., no residual disease), studies have been showing this tends to correlate to longer remission. I sure hope your mother reaches this point - it's quite a psychological (and emotional) boost when you're told they basically cannot find evidence of the disease in your system.
The MRD test is also done quite often in clinical studies. I had the test done after reaching sCR in the clinical study I was in with Carfilzomib, Revlimid, and Dexamethasone for newly diagnosed patients. As Mark indicated, if the tests come back negative (i.e., no residual disease), studies have been showing this tends to correlate to longer remission. I sure hope your mother reaches this point - it's quite a psychological (and emotional) boost when you're told they basically cannot find evidence of the disease in your system.
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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: Minimal Residual Disease
Hi Kevin,
Thank you for the response. The result from the flow cytometry done with my mom's BM cells was MRD negative. We are very happy with the result, and pray for the continued good outcome.
Thank you for the response. The result from the flow cytometry done with my mom's BM cells was MRD negative. We are very happy with the result, and pray for the continued good outcome.
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dnalex - Name: Alex N.
- Who do you know with myeloma?: mother
- When were you/they diagnosed?: 2007
- Age at diagnosis: 56
7 posts
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