I
still have chronic lymphocytic leukemia; however, I am still in clinical complete remission. I am grateful. It has been six years on ibrutinib.
Patients in the NIH study I am participating in,
who have relapsed on ibrutinib, have had prior treatment. None of the patients
who have taken Ibrutinib as a frontline treatment for CLL with 17p deletion
have relapsed in the study. That is incredibly good news for me.
Minimal residual disease (MRD) negative status
is reached when counts are less than 0.01 percent. MRD negative status has not
been found in 17p deleted participants on one drug. My last cytometry test
revealed that my counts are 0.09 percent… close, but no potato.
Those participants who have reached MRD status
often wonder whether they could stop taking the drug. Dr. Adrian Wiestner is my
doctor at the National Institutes of Health in Bethesda, Maryland. While there
is a push for stopping treatment with Ibrutinib after a fixed time, he believes
there is a strong scientific argument to continue the B-cell receptor
indefinitely.
Latest advances in technology
have made it promising to detect evidence of cancer – minimal residual disease
(MRD) – that continue even when traditional tests come up good.
Two Phase II studies of
a German CLL study group discussed the value of MRD negative status (Kovacs et
al, 2014). Here is the take-away: Both
MRD negativity (with a threshold of <10-4leukemic cells
per leukocytes) and the occurrence of a complete response (CR) predict long
progression-free survival (PFS). This means a longer time without disease growing back. Perhaps this
will be a prerequisite for a cure.
Take
care my friends. I am hanging in there for the long haul.
