Clinical Remission and/vs Tumor/Lesion Growth (Question) - Myeloma Chat - WELCOME!


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DougC
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My question is, can you have clinical complete remission (Labs and Bone Biopsy) and still have tumor and lesion growth/progression? If so, can you explain how that works? Also, if so, what does it mean? Does it mean the myeloma is active? Or is it some other plasma protein variance that's causing the activity?

I believe I read a Dr. Tricot and MIRT study that talked about how there can be as much as an 18-24 lag time between benefits derived from transplant that are evident in the bone involvement (tumors/lesions), but I don't recall reading anything that addresses my question.

Anyone have any thoughts?

Thanx

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Hi Doug,

I passed your question on to Dr. Tricot, and here is his answer. I hope this answers your question, but let us know if there's a part of your question we're not addressing.

Dr. Tricot says:

You can be in remission while there are still abnormalities on a skeletal survey, CT scan, and MRI. Bone lesions typically do not heal even after eradicating all the myeloma. MRI lesions are usually slow to disappear. Sometimes, patients can be in remission for more than 18 months before the MRI will normalize.

DougC
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So, a tumor doesn't continue to grow while in clinical complete remission, right?

Thank you for the response

Doug

Annick
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It is not possible to have tumor or lesion growth and be in a complete remission. It is possible, however, that there are still inactive MM cells present somewhere in the body that we are not sophisticated enough yet to detect with current diagnostic tools, which is why some patients eventually relapse/progress. Make sense?

DougC
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Sure, that makes sense and I understood that to be the case. However, I guess what was confusing me recently was the difference between stringent remission and complete remission. I had understood...possibly misunderstood...that focal lesions were the difference between the two. With me drawing that conclusion, I wondered if it was possible to have active myeloma detected in the bone lesions while not being detected clinically.

Thank you Annick for clearing that up for me