Question about Surface Markers and Immunophenotype in AML

Hi @jalan00. Just checking in with you to see how your dad is doing now that he’s gotten through his first cycle of Azacitidine and Venetoclax. These two medications are often used together and are particularly effective for older adults with AML who are not candidates for intensive chemotherapy.

Regarding the of Immunophenotypic Analysis, the information listed such as CD33, CD45, etc., are commonly expressed antigens for AML. Most of us with AML will have had similar testing with varying comments unique to our own cases. But since they are specific to each patient, this is information for your dad’s doctor to interpret.
The good news is that you mentioned he is negative for the FLT3 mutation, which was often the ‘problem child’ of mutations giving our doctors a challenge with treatment. There is a targeted drug for that mutation now which works well. I was able to use that in conjunction with chemo.

Even without NGS (next generation sequencing) available, your dad’s doctor seems very knowledgeable, has run sophisticated tests and is using first-line treatment for your dad’s AML. His doctor will be able to interpret the tests results and should be willing to discuss them with you.

From personal experience, it can be helpful to have the list of questions or concerns written down in a notepad or even your phone, so that you can go right down the list. It’s so easy during appointments to have conversations take a different direction and we forget important items we wanted to discuss. So having it written down helps to bring the focus back.

When is your dad’s next appointment to speak with his doctor? Has he had any bloodwork since his last cycle ended?

@loribmt Hello. It's been a while since I logged in here.
Thank God the week before the second cycle his blood count bounced back up.
Platelets from 17 to 298
Wbc from 0.92 to 2.7 with 56% neutrophils
Hemoglobin is 9.1 from 7.1

After the second cycle, his counts still remained steady with hemoglobin rising up to 9.7 and wbc bounced to 7.3 and platelets at 251. It's been a week since his second cycle was finished.

I asked our doctor if they would do another BMB but they said it was still too early and would do it after a few more cycles. I still worry a bit if this is considered an exceptional response or something to be expected. I still find it a bit hard to feel at ease since there's so many different responses from the same medication.
I continue to pray that he would also be a part of those with exceptional results

Hi @jalan00 It’s often the same process monthly with each round of chemo. The blood numbers will drop and then the week before the next round begins, they tend to rise. It’s just the nature of chemo.
Chemo interferes with rapidly dividing cells, such as cancer cells. It’s not discriminatory however. So chemo also destroys or interferes with other rapidly dividing cells such as blood cells, hair follicles, the mucosal lining in the digestive tract, etc.. Mid month, the blood numbers will drop to a very low point called nadir or neutropenia. It will take a week or so after that for the numbers of cells to regenerate, often just in time for another round of chemo.
In my own experience, each month the numbers of cells regenerating seemed to be slower to rise. So don’t be alarmed if this happens. It can take longer in some patients. But the cells usually return to normal or near normal on their own terms.

Usually another BMB isn’t warranted this early in your dad’s treatment. There’s a lot of information available in the blood draw results as to how the treatments are working. There will be another BMB at some point. But for now, it appears your dad is reacting favorably to the treatments. So you can breathe a little easier and trust the process! Your dad’s progress sounds right on track.

I’m here any time if you have questions! Keep me updated, ok? Hugs.