On November 12, my husband had several tests to assess him for SCT. The results are in, but I am not sure if he is in remission. We meet next week with the doctors.
Diagnosis
Urine/MSpike - 9.0
Creatinine - 6.6
Kappa Light Chains - 518
After Round 4 of Chemo
Urine/MSpike - No M-Spike
Creatinine - 3.8
Kappa Light Chain - 21
Is he in remission? What defines it?
Forums
5 posts
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LadyLib - Name: LadyLib
- Who do you know with myeloma?: Spouse
- When were you/they diagnosed?: July 2013
- Age at diagnosis: 42
Re: Remission?
I don't know that the term remission is important. More important is that when they draw the stem cells they percentage of healthy cells should be very high. He will then start with few if any cancer cells.
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Wayne K - Name: Wayne
- Who do you know with myeloma?: Myself, my sister who passed in '95
- When were you/they diagnosed?: 03/09
- Age at diagnosis: 70
Re: Remission?
Not quite enough information to comment about response. Generally though, normalization of the light chain is a very good thing.
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Dr. Jason Valent - Name: Jason Valent, M.D.
Beacon Medical Advisor
Re: Remission?
My understanding is that "remission" is often used interchangeably with "response" among a lot of people when they talk about how patients have responded to treatment.
Technically, though, I think there's a difference, in that "remission" is really supposed to be reserved for those cases where a patient really has no more signs of having myeloma. I am not sure, however, whether this means that a patient has to have had a "complete response" or a "stringent complete response" to be (technically) considered to be in remission, or if they may even be required to have achieved negative minimal residual disease status.
The bottom line, though, is that what you really want to know is the kind of "response" your husband has had to his treatment. Has he had a partial response? A very good partial response? A complete response? And so on.
The reason response matters is because studies have shown that the better a patient's response to treatment, the longer (typically) the patient can be expected to go before they will relapse, and the longer the patient's expected long-term survival.
This discussion here in the forum points to some useful resources that define the different kind of responses to treatment in myeloma, and also summarizes the definitions:
https://myelomabeacon.org/forum/calculating-response-to-treatment-t2424.html
You'll see why Dr. Valent said that more information is necessary because, for a patient to be said to have achieved a complete response, the following conditions must hold:
Negative immunofixation of serum and urine, AND
Disappearance of any soft tissue plasmacytomas, AND
Less than 5% PCs (plasma cells) in bone marrow.
You did not say what the percentage of plasma cells are in your husband's marrow, and that information is necessary to determine if a complete response has been achieved. You also only reported the urine M-spike results and no serum protein results.
All that having been said, the urine m-spike results for your husband look very promising!
Technically, though, I think there's a difference, in that "remission" is really supposed to be reserved for those cases where a patient really has no more signs of having myeloma. I am not sure, however, whether this means that a patient has to have had a "complete response" or a "stringent complete response" to be (technically) considered to be in remission, or if they may even be required to have achieved negative minimal residual disease status.
The bottom line, though, is that what you really want to know is the kind of "response" your husband has had to his treatment. Has he had a partial response? A very good partial response? A complete response? And so on.
The reason response matters is because studies have shown that the better a patient's response to treatment, the longer (typically) the patient can be expected to go before they will relapse, and the longer the patient's expected long-term survival.
This discussion here in the forum points to some useful resources that define the different kind of responses to treatment in myeloma, and also summarizes the definitions:
https://myelomabeacon.org/forum/calculating-response-to-treatment-t2424.html
You'll see why Dr. Valent said that more information is necessary because, for a patient to be said to have achieved a complete response, the following conditions must hold:
Negative immunofixation of serum and urine, AND
Disappearance of any soft tissue plasmacytomas, AND
Less than 5% PCs (plasma cells) in bone marrow.
You did not say what the percentage of plasma cells are in your husband's marrow, and that information is necessary to determine if a complete response has been achieved. You also only reported the urine M-spike results and no serum protein results.
All that having been said, the urine m-spike results for your husband look very promising!
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JimNY
Re: Remission?
Thanks for the information - very insightful.
His BMB showed less than 2% of cells. He was 50% at diagnosis.
At time of diagnosis, there were no significant lesions - the skeletal survey provided this.
The urine was negative for all signs of multiple myeloma
His BMB showed less than 2% of cells. He was 50% at diagnosis.
At time of diagnosis, there were no significant lesions - the skeletal survey provided this.
The urine was negative for all signs of multiple myeloma
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LadyLib - Name: LadyLib
- Who do you know with myeloma?: Spouse
- When were you/they diagnosed?: July 2013
- Age at diagnosis: 42
5 posts
• Page 1 of 1