MRD assessment in CLL

[Jm954]

Nice explanation of MRD testing and it's use for guiding treatment.

ASCO 2019 | MRD assessment in CLL - Dr Danielle Brander

Measurable residual disease is playing a larger role in treatment assessment of chronic lymphocytic leukemia (CLL). This topic is explored by Danielle Brander, MD, of the Duke University School of Medicine, Durham, NC. This interview was recorded at the American Society of Oncology (ASCO) 2019 Annual Meeting, held in Chicago, IL.

vjhemonc.com/video/njo_qk7k...

Jackie

[Phredie]

Thanks for sharing Jackie. Looks like only healthcare professionals are permitted.

[Jm954 Administrator in reply to Phredie]

It doesn't ask me that, what nuisance - just confirm you are? I'll see if I can find a transcript.

Jackie

[avzuclav in reply to Phredie]

You can skip filling in the blanks and press Continue and it works just fine...

[avzuclav in reply to avzuclav]

Also you can watch directly on YouTube here:

youtube.com/watch?v=NJo_Qk7...(Not working as expected?)

[David73]

Yes, I’ve just pressed continue as explained by avzuclav and it works. What a clear description of measurable residual disease in CLL!

It certainly is clear that there is soon to be the possibility of being on these novel treatments, like Ibrutinib, for a defined period and then back to active monitoring. Wow!

[Sushibruno in reply to David73]

Wow🙂

[Wroxham]

A fixed duration of treatment sounds

great. If available.

Thanks Jackie

[studebaker]

Thank you Jackie. Hopefully, the limited treatments with combined, no chemo medications will be a cure for us.

Dana

[GrapeGrower1]

Awesome explanation

[JigFettler Volunteer]

Thanks Jackie - I was declined an MRD status assessment after FCR on the NHS on the basis that the result would not change what happens next for me, namely W&W #2!

All I have is the rate of response I had to FCR, as perhaps a surrogate indicator of depth of response, and Prof Hillmen urging me to do the full 6 cycles.

Jig

[Jm954 Administrator in reply to JigFettler]

That is true, nothing changes by knowing except, perhaps, more peace of mind going into the future.

Jackie

[JigFettler Volunteer in reply to Jm954]

Yeh! and thats worth more to me thn the NHS I guess! Jig

[teakbank12]

Jig

I asked after FCR 6 cycles had finished about MRD & haemo looked at me as if i had two heads and she was a very helpful consultant.

Now i have a useless replacement who keeps changing every visit i have

Dave

[Jm954 Administrator in reply to teakbank12]

[cajunjeff]

Very interesting, thanks for posting.

In the nitpicky pet peeve department, I dislike when doctors repeat the mantra that outside of a stem cell transplant, cll is not curable.

A very significant number of people with mutated cll taking fcr are cll free at 20 years out. In what other type cancer does a twenty year remission not equate to cure? Heck, most of us are diagnosed in our 60s or 70s.

The progression free survival curve for FCR and cll tends to flatten out around ten years. That means for those who make it to ten years, you are not likely to relapse. You might, but you probably will not.

That is important because if FCR can give indefinite remissions (I think cure is a better word), then why not the new agents? And since new agents work on most types of cll, why is it not fair to think that most all of us have a chance for being cured, even with existing technology.

Cll is a challenging disease which deserves our full attention. But please stop saying its not curable just because that is what you learned in med school. People are being cured with cll. My plan is to get cured, although I am still working out the details of that.

[Sushibruno in reply to cajunjeff]

This gives me some comfort🙂.