Help needed to interpret report 🙏🏻🙏🏻🙏🏻

[Seok]

Hi Everyone, special shout-out to Jackie 🎤

My friend just received the attached report this morning; two months after V&O treatment.

She is very anxious as it didn’t look good and wondering what it means and what questions to ask her hematologist tomorrow. Please help!

Seok

[cajunjeff]

I am no expert at reading these reports, but I will give it a go. It appears your friend had a flow cytometry test to see if she was mrd - negative (or mrd - undetectable, as some call it). MRD stands for minimum residual disease and it looks for what % of cells are cll cells left after treatment.

Different tests have different sensitivity capabilities and some tests can look a lot deeper into it than others.

It looks to me like your friend is very close to having no detectable cll cells lurking around after treatment - there is a .08 % of cells (way less than 1%) that look suspicious for being cll cells because they overexpress the cd5 molecule, a sort of fingerprint for cll cells.

So I would interpret the test as being very close to being mrd negative with an almost undetectable amount of cll cells left.

Since cll cells tend to multiply, if there is some small population of cll cells found on the flow test, its likely at some point you fall out of remission. A not insignificant number of people who got mrd negative after FCR, however, never progressed. So there is that hope out there that a treatment like O plus V can eradicate all cll cells such that it never returns.

I would think having those results after only two months of treatment is excellent . Maybe another month or two of V plus O wipes out the suspicious cells they are seeing.

[Seok in reply to cajunjeff]

Oh blimey, I meant 2 months after she has completed 1 year of V&O treatment. Thanks cajunjeff for your reply which made me realized my mistake.

[Jm954 Administrator]

Hi Seok,cajunjeff has it pretty much correct. Good to see so many subtypes of lymphocytes which will help with immunity. The Myeloid/lymphoid ratio is probably to be expected as Venetoclax suppresses myeloid cells and, from the report, there are no cells of concern within that group.

This is so close to being U-MRD at 0.08% CLL cells. The report is saying they are at a level below their threshold (for accurate counting) of 8 per 10,000. That would qualify as very low MRD and a pretty good result although disappointing that they are not quite U-MRD.

It might be worth having the test repeated in 3 months and see if they have fallen further or they are slowly increasing which would be more cause for a bit of concern. Hopefully by then her neutrophils will have also have increased too.

Hope this helps,

Jackie

[Seok in reply to Jm954]

So thankful for your reply Jackie. I’m sure my fried will be comforted too.