Minimal residual disease result - what to expect

Hi everyone,

I’m a 27 year old male and was diagnosed with Acute Myeloid Leukaemia last September after several months of feeling unwell. I was placed on a chemo-only treatment pathway because of my Acute Myeloid Leukaemia’s genetic mutations, which was all well and good until my blood counts decided not to recover properly after my second cycle of chemotherapy. It has taken them c.4 months to return to normal since chemo (although thankfully they’re almost there now).

My consultant is now waiting on my minimal residual result before they decide how, and if, my treatment will continue. I’ve been told if the result is negative, then I won’t need further treatment and will simply have monthly blood tests/three-monthly biopsies going forwards. If it’s positive, I will probably need a bone marrow transplant as my consultant is not confident my marrow could take another round of chemo.

So, to my question: what can I expect from my MRD result? I know it’s usually expressed as a percentage of leukaemia cells in your bone marrow and if that percentage is over a certain amount, it is seen as positive. But otherwise, I haven’t got a clue! I’d really appreciate some clarity on this before I get my result, hopefully in the next couple of weeks.

PS: my Acute Myeloid Leukaemia is t(8;21) RUNX-RUNX1T1, so theoretically good prognosis - although I’m not sure if not having the last two rounds of consolidation chemo will affect that…

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Hi @Charles96 a great big welcome to our forum and I am so glad that you have found us.
You certainly have embraced ‘medical speak’.
I am useless on anything medical.
A lot has happened to you since September.
I will copy your post to the Blood Cancer UK nurse advisors @BloodCancerUK_Nurses in case they can add anything.
I know you wanted to know before your next appointment, otherwise this question is best asked of your consultant.
If you wish to talk to the Blood Cancer UK support line their number is 0808 2080 888.
Please let us know how you get on and look after yourself

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Hi @Charles96 welcome to this forum, I really hope you find it helpful. Sorry to hear of all you’re going through at the moment. It’s so understandable you’re looking for clarity around the MRD test and what to expect.
The MRD test is an extremely sensitive assessment of the leukaemia cells in the bone marrow. It’s now used worldwide as the gold standard for assessing how someone has responded to their initial treatment and helps doctors to plan whether they should increase or decrease the intensity of subsequent treatment.

As you’ve said in your post, an MRD positive test result means that residual (remaining) disease was detected. A negative result means that residual disease was not detected.

Your treating team will be reviewing the number of remaining leukaemia cells shown by the MRD test, and if it shows that the number is reducing then that will be reassuring, and they will keep testing this every 3 months, as you’ve said, to see if it’s decreasing. You may find it useful to ask your consultant if they can explain the test to you in terms of what the numbers are now, and what they’re looking for next time, and what a reassuring result would be in your individual circumstances.

Our counterpart organisation in the US has a good factsheet on MRD in case it’s useful for you - FS35_MRD_Final_2019.pdf (lls.org). Some bits won’t be relevant as it’s in the context of the US but it explains what the test is in detail.

We’re only at the end of the phone if you want to talk any of this through and we’re here to support you now and going forwards. Wishing you all the best with your results.

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Welcome @McLean1 to posting on our forum.
I look forward to hearing more about you and if you would like to speak to someone the Blood Cancer UK support line is there for you on 0808 888 2080.
Look after yourself