More on MRD

[Smakwater]

To further the discussion on MRD, here is a commentary from a known and reliable source "Patient Power"-

patientpower.info/chronic-l...

Although not the reliable source referenced, the picture is a Sprezzatura Smakwater Girl named Sugar.

[CLLCalifornia-USA]

Great article worth sharing. Thanks.

Sugar is beautiful. I have two yellow labs and they are always at my side. Great companions. Enjoy. Sally

[Smakwater in reply to CLLCalifornia-USA]

Two Yellows! You are Lucky!

[bennevisplace]

Thanks for this Smakwater, and for the photo of your lovely lab who is evidently cut out for a career in modelling.

In an attempt to clear up lingering questions around MRD, a couple of years ago a bunch of heavyweight authors put out a comprehensive paper nature.com/articles/s41375-... in which "we present the work of an international, multidisciplinary, 174-member panel convened to identify critical questions on key issues pertaining to measurable residual disease in chronic lymphocytic leukemia, review evaluable data, develop unified answers in conjunction with local expert input, and provide recommendations for future studies".

Table 2 from that paper, which deals with nomenclature, packs a lot in. Note that "Undetectable-MRD” (U-MRD) is preferable to “MRD-” or “MRD negative” (the latter being used in the Patient Power article). However, the rationale for the suggested nomenclature leads to MRD4d (detectable) versus MRD4u, which seems to me to be splitting hairs. Why not just MRD (MRD4) versus URD (URD4) ? You have to read through the text to judge.

I don't know what the latest thinking on MRD is, but surely it must be time for another giant multidisciplinary panel to chew on it again. A question for them (or anyone else):

If MRD status at the end of fixed duration treatment correlates with TTNT/ PFS/ OS in CLL patients, does the same apply in SLL patients?

[Smakwater in reply to bennevisplace]

Spot on bennevisplace. Even though the greatest level of uMrd is not a guarantee, it seems to becoming more of a factor in longer duration remission with the discontinuation therapy. I am still part of that experiment, and I hope that over time this become more the norm especially for the high risk groups such as mine that have not previously responded well to earlier treatments.

There is something about being told "We cannot see any cancer cells in one million cells observed" that just seems to calm the noise at the moment.

[Mystic75]

Thank you so much for posting. It’s great that it includes questions to ask the doctor. 👍

D.