The Leukemia & Lymphoma Society - Fighting Blood Cancers
4 Replies Last post: Oct 8, 2009 12:00 PM by Tex  
DebraW   9 posts since
Sep 26, 2009
Currently Being Moderated

Oct 6, 2009 6:45 PM

Results from Bone Marrow do not show remission

Hi again,

We finally got my daughter's Bone Marrow biopsy results.  They do not show remission, she still has 15%  blasts the doctor said that they need to be at 5% to be in remission, she did come down from 100% blasts.  So now she is going back into the hospital for another 8 rounds of chemo to get her into remission before the transplant. I thought that she needed to be in complete remission at this point in order for the transplant to be a success - that transplants don't work well enough if the patient is not in remission at this stage?  Her doctor says that she is still optimistic that everything will be ok and that this isn't a major setback....is she being truthful? has anyone else experienced this?

Debra

Tex   2,856 posts since
Apr 3, 2009
Currently Being Moderated
1. Oct 7, 2009 1:54 PM in response to: DebraW
Re: Results from Bone Marrow do not show remission

Not sure I'm understanding this correctly.  If the chemo she's going in for is designed to treat the disease, there should be no problem at all.

 

Yes, they prefer a patient to be in remission before they start the transplant process.  Some places won't do it otherwise but some will.  What they explained to me is there is statistically a better chance of success if the patient is in remission.  They never indicated it was impossible.

 

Here's where I'm confused.  This doesn't sound like the conditioning chemo they give immediately prior to transplant.  That's the chemo designed to destroy the marrow in a myeloblative transplant or, in the case of a "mini" transplant to damage it as much as they need to give the graft a chance to grow.

 

It would only be if they were starting conditioning there would be any concern at all.  As I said above that's usually only a statisitcal concern.  (I mean, they probably wouldn't do one with 80% blasts present.)  But if this is just taking another shot at getting her into remission, this wouldn't have any impact on the transplant at this time.

 

The fact they took her from 100% to 15% makes it very hopeful the next chemo therapy will be able to knock it all out.

 

I can't remember is you've posted on the transplant forum or not.  If not, please join us there.

 

Blessings

pamd   990 posts since
Apr 3, 2009
Currently Being Moderated
2. Oct 7, 2009 4:39 PM in response to: DebraW
Re: Results from Bone Marrow do not show remission

Like Tex, I'm a little confused about the type of chemo she's doing prior to transplant, but your other question---is it normal not to get into full remission on the first try, yes, that happens to many of us. I think it's certainly a major step in the right direction to go from 100% blasts way down to 15%. In my case, when I relapsed from AML I only had 25% blasts, my first induction chemo only dropped my blasts to 20%. It took another round of stronger chemo to get me into remission. Some folks need another round after that. I wonder if you mean 8 days of chemo, rather than 8 rounds? Also, I don't know what type of blood cancer your daughter has (you've no doubt said and I just missed it), so maybe that makes a difference here. But I would stay optimistic, folks often do need more than one go with chemo to achieve remission, so keep positive! And as Tex said, we have an active transplant board here, so join us when you're ready!

 

Pam

Tex   2,856 posts since
Apr 3, 2009
Currently Being Moderated
4. Oct 8, 2009 12:00 PM in response to: DebraW
Re: Results from Bone Marrow do not show remission

Okay, I understand better and my original thoughts remain in place.  Your daughter's been responsive to chemo.  There is absolutely no reason to think that won't continue.  (Okay, doouble negative.)  Ahem...there is every reason to expect that will continue.

 

Both Pam and I were AML patients.  I don't know much about ALL or its protocols.  But when we become transplant patients a lot of the distinctions dissolve.

 

Anyway, I'd expect her to reach remission with this part of her chemo.  Then it should be full steam ahead to transplant.

 

Hope this helps.

 

Blessings

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