Treat to Zero? Bone marrow shows zero CLL cells but flow cytometry shows 0.06 residual CLL cells. Doc wants to continue FCR treatments?

[irish828]

[Cllcanada Top Poster CURE Hero]

Minimal residual disease or MRD negative which is what is strived for, is 1 malignant cell in10,000 leukocytes. The CLL GUIDELINES state..

'The techniques for assessing MRD have undergone a critical evaluation and have become fairly standard. Either 4-color flow cytometry (MRD flow) or allele-specific oligonucleotide PCR is reliably sensitive down to a level of approximately one CLL cell in 10 000 leukocytes. As such, patients will be defined as having a clinical remission in the absence of MRD when they have blood or marrow with less than one CLL cell per 10 000 leukocytes. The blood generally can be used for making this assessment except during the period within 3 months of completing therapy, particularly for patients treated with alemtuzumab, rituximab, and other antibodies targeting CLL. In such cases, it is essential to assess the marrow for MRD. '

bloodjournal.hematologylibr...

~chris