Sunday, June 28, 2015

Morphological Remission-Explained!

We finally received the results of Meg's last MRD (minimal result disease) test.  It came back negative and that is exactly what we needed to hear! You'll remember that Meg "failed" this test two times prior so this was a really big deal that the results of this one came back in our favor. As a reminder, test one was on day 8 of treatment and the expectation was that her leukemia would be in remission already (which blows my mind!) with less than 1% of leukemia cells in her body. She had 2.5%. We were bumped from a standard risk patient to a high risk one. On day 29,the percent we were shooting for was 0.01% or less. She was at .68% bumping us yet again, this time to very high risk. The third and most recent test she again needed to be at 0.01% or less or we would be looking at a bone marrow transplant. Thankfully, the text above, giving us the good news, was sent to us on Thursday, by Megs' head nurse, Carrie, and Meg did it! The chemo is FINALLY working like it should, there is 0.01% or less of leukemia cells in her body, putting her in remission and we are ever so grateful!

Since announcing the results we have had many people misunderstand the news and think, "she's in remission. She's done!" WE ONLY WISH! Even though Meg is "in remission," we still have two years of treatment to go and Meg is still considered a very high risk patient. That will never change.  "Well, why is that? If she's in remission, why does she still have treatment and why is she still considered very high risk?" people want to know. I'll do my best to explain. (With a little help from some "professionals.")


"At this point, the patient is judged to be in clinical and hematologic remission, although the term "remission," much loved by hematologists and patients, refers only to a somewhat arbitrary point toward one end of a continuum of leukemic-cell numbers."

Translation of the above:  When you consider that we have millions of cells in our body, even with 0.01% or less of them being leukemia, that's still leukemia cells. And the problem with cancerous cells is this.....THEY DIVIDE which means they MULTIPLY. So, if even one miniscule little leukemia cell is left unchecked in Meg's body it will become two. Which will become 4. Which will become 8. Which will get the picture. So, chemo must go on!


"Although doctors know that clinical remission does not mean that the disease is eliminated, the term still has value as a prognostic factor in treatment. For example, careful studies have determined that patients that do not go into clinical remission by day 14 of treatment are at higher risk for relapse, and therefore these patients, called "slow early responders", enter on a more intense treatment regimen. Rapid early responders are able to complete a less intense treatment protocol."

Translation of the above:  Because Meg's leukemia did not go into remission by day 8, which is the expectation or even by day 29 of treatment she was placed in the very high risk category. This does put her at a higher risk of recurrence and therefore they continue to leave her on the very high risk treatment plan. She will continue on this plan for the entirety of treatment. Once you're very high risk you never get to go back.

I hesitated to write this because I know it kind of sounds like a DEBBIE DOWNER post! But, this is the truth of it and I wanted to be able to clear up any misconceptions. But please don't misunderstand me or this post and please know, we are SO VERY GRATEFUL that even though it took some time, things have turned around, the chemo is working, Meg is still in amazing spirits and feeling great, and we recognize the hand of the Lord in our life everyday! Thank you for your prayers. They helped us get this miracle that we needed. That's truly what it is. A miracle.

1 comment:

Kirsten said...

Thanks so much for writing this and clarifying! It didn't sound like a downer at all; Meg has gone through so much and hopefully it's only up from here! We keep praying for her and all of you!