Measure CLL remission from date of treatment? - CLL Support

CLL Support

23,336 members40,042 posts

Measure CLL remission from date of treatment?

DinosaurDad profile image
8 Replies

Folks: I seem to remember that someone posted on this recently. My specific question: I thought that "remission" is typically measured from, for example, the day you're taken off medication. But I believe I saw a post referencing an article that said remission is typically calculated from date when you started treatment?

I was thinking this would be relevant especially when you look at trial results, which have calculations like PFS (progression free survival).

Maybe someone out there can help me understand?

Thank you

Written by
DinosaurDad profile image
DinosaurDad
To view profiles and participate in discussions please or .
8 Replies
Jm954 profile image
Jm954Administrator

Hi there,

Generally, neither the start of your treatment or the end of your treatment is the date of remission. It is normally the date when investigations show you are in remission.

So, for example - start V+O in January 2022 then CT scan and then measurement of MRD in July 2022 to assess response to treatment. If there is resolution of all nodes and no disease detected then the date of those investigations (or the report) is the date of remission. That would be a CR - complete remission but sometimes there are a few nodes still slightly enlarged and a few CLL cells - that would be a PR or partial remission and the investigations would probably be repeated at a later date which could then qualify as a CR if no disease is found.

If an increase in disease is detected following a PR or CR then that is relapse and the date of relapse is the date it was detected.

Jackie

DinosaurDad profile image
DinosaurDad in reply toJm954

Thanks for your response. I did find the reference article that was quoted in the post I read recently. It speaks more specifically of the definition of PFS, and perhaps this is mainly referencing other types of cancer. Link is below.

thelancet.com/journals/lano...

I guess the key question is: when we read a study like the CLL14 study, which details PFS within a number of patient groups, PFS appears to be calculated from "randomization" - which I understand to be when trial participants are placed in test groups. See below link to a recent study results article :

nature.com/articles/s41467-...

DinosaurDad profile image
DinosaurDad in reply toDinosaurDad

aha! I found the thread I was referencing:

healthunlocked.com/cllsuppo...

AussieNeil profile image
AussieNeilPartnerAdministrator in reply toDinosaurDad

My mistake, now corrected. I meant to say "You still need to show significantly more than a year of additional progression-free survival for each additional year of treatment, because progression-free survival is measured from when you start treatment". I incorrectly said remission, not progression-free survival.

DinosaurDad profile image
DinosaurDad in reply toAussieNeil

Thanks for clarifying. You're an outstanding administrator by the way! Appreciate everything you do.

Jm954 profile image
Jm954Administrator in reply toDinosaurDad

In clinical trials they always use the date of randomisation, not even start of treatment because they definitely know that date for PFS. That eliminates the potential variability of the timing of the assessment of response.

DinosaurDad profile image
DinosaurDad in reply toJm954

Appreciate your feedback!

CClaver27 profile image
CClaver27

My doc initially said remission was calculated from the last treatment. But, then my next Oncologist stated it was 6 months after the last treatment since there was no residual disease present that returned. I'm not sure which one was right..

Not what you're looking for?

You may also like...

CLL REMISSION.

I am in remission from CLL, since Christmas 2019. How can I tell if it is coming back, because I...

Out of Remission

Well, I got some not so good news today. I had my CLL check today and I'm out of remission. My WBC...

Choice of CLL Treatment

HI all, I’m 53 and after 5 years I’m nearing the end of W&W and my oncologist is suggesting I start...
Murphy63 profile image

How is "remission" defined for CLL?

After being on Ibrutinib for 8 months, my numbers are all back in the normal range. My oncologist...
Living2 profile image

Out of remission

I had Rituxan/Bendeka treatment through a port about 18 months ago. It worked really well and I...
J-girl profile image

Moderation team

See all
CLLerinOz profile image
CLLerinOzAdministrator
AussieNeil profile image
AussieNeilAdministrator
Newdawn profile image
NewdawnAdministrator

Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.

Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.