Today we got the results of Clara's MRD from the round two of chemotherapy. If you remember, this is a measure of the amount of leukemic cells versus non-leukemic cells in her bone marrow. An ideal number is 0% (or as they can measure it would be < 0.01%). After the previous round of chemo we were had bad news about MRD (as it being low is one of the best prognostic indicators).
Her results today are pretty good: 0.21% MRD. This is not remission and not the optimal scenario for stem cell transplant. However, we will be moving forward to transplant within the next few weeks without another round of induction chemo.
Disturbingly, we also discovered that the original MRD measurement which we though was 12% was actually a mistake on the part of our attending and it should have been 0.12%. This error came up with a new reporting method that they are using (it sounds as if they get a spreadsheet back and the new report provides a % while the older method did not. The attendings inappropriately assumed that they had to shift two decimal places (ignoring the % that was already there). Luckily the value difference wouldn't have changed the treatment.
As I said these results have the doctors wanting to start transplant as soon as possible. We have two matched donors now and will be transplanting based on their availability. We also have to wait for Clara's white cell counts to recover a bit before the preparatory chemotherapy because that significantly reduces the risk of infection during the time where she has no immune system. We are looking at probably 2-3 weeks until transplant.