Question concerning NED (No evidence of disease) and MRD
I have favorable risk AML and have successfully completed both my induction and consolidation chemotherapy. A biopsy performed in the hospital during induction indicated remission. A few weeks after discharge, I guess my oncologist noticed something slightly abnormal in my blood counts, so he ordered another biopsy. The results came back within 48 hours as follows:
“ BONE MARROW CORE BIOPSY, ASPIRATE CLOT, SMEARS & TOUCH IMPRINT:
- HYPERCELLULAR MARROW (60-70% CELLULARITY) FEATURING ACTIVE TRILINEAGE
HEMATOPOIESIS WITH PANMYELOID HYPERPLASIA AND NO INCREASE IN BLASTS (1%).
- NO MORPHOLOGIC OR DEFINITIVE IMMUNOPHENOTYPIC EVIDENCE OF RESIDUAL ACUTE MYELOID
LEUKEMIA.”
I took this to mean simply that there was no evidence of disease (NED) but that it said nothing about MRD being positive versus negative.
1. Is my interpretation seem correct? Also, what’s all that verbiage prior to “blasts (1%)” actually mean?
2. My post-consolidation blood counts have returned to normal, and I[m having a biopsy done this coming week. My understanding is that an MRD test will be done via flow cytometry.
I know that no prediction can be made with certainty regarding the outcome of the MRD test, but I am feeling reasonably hopeful it will be negative.
Has anyone had a biopsy come back showing NED but with a positive MRD result? If so, how did you and your oncologist proceed? Did you just continue to monitor via subsequent biopsies? Did you proceed directly to a transplant? I realize everyone’s case is different, but I’m interested in hearing from somebody.
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