I am searching for sensitive markers for monitoring efficacy of therapy. I need help please.

[JerryW]

[David39]

I see you've asked the same question several times before. I'm afraid you're unlikely to get a response that's any different from the last 4 times you posted. As previously recommended, your best source of help on this, is your doctor.

[JerryW in reply to David39]

Thanks for your response.

JERRY

[CLLSA CLLSA]

Dear Jerry,

monitoring the efficacy of treatment is both simple and complicated!

1) Simple - are the blood counts improving? Are the lymph nodes/liver/spleen - if enlarged at the start of treatment - shrinking? If you had drenching night sweats, high fevers, weight loss before treatment, are they getting better?

2) Complicated - measuring very low levels of CLL in patients who have made a good response (ie, a complete response or a good partial remission) in the standard ways assessed in (1) above. The current preferred option is to look for very low levels of CLL cells in the blood (and/or bone marrow) by a technique called "flow cytometry", either during or after completing treatment. This cannot be explained very easily in this email exchange , but the CLLSA website does address "minimal residual disease (MRD)" monitoring. Your doctor/clinical nurse specialist should be able to help to explain further.

The big question is what should be done if MRD is detected? This is still not known and the current standard is to NOT treat on the basis of MRD results alone (unless treatment is part of a clinical trial).

This can become confusing, so please do ask your own consultant.

Best wishes,

Dr Samir Agrawal