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Glossary Results

Minimal Residual Disease (MRD)

The small amounts of cancer cells that may remain after treatment. These cells are only identified by sensitive molecular techniques.

Relapsed Disease

Disease that initially responded to therapy but has begun to progress.

Refractory Disease

A disease that does not go away or improve much after initial treatment.

Graft-Versus-Host Disease (GVHD)

A disease that happens when the donor cells (“the graft”) attack the cells of the patient (“the host”). Most often this disease attacks a patient’s skin, liver, and the stomach and gastrointestinal tract.

Disease subtype

A term used to describe a form of leukemia, lymphoma, myeloma, myelodysplastic syndromes and other diseases. The disease subtype is often important in determining how to treat the patient.

Veno-occlusive disease (VOD)

A disease that may be a complication following high-dose chemotherapy and/or radiation, in which the blood vessels that carry blood through the liver, swell and become clogged.

Nonsecretory Disease

In a small proportion of patients with myeloma, no abnormal protein can be detected.

Oligosecretory Disease

In a small proportion of patients with myeloma, the level of abnormal protein that is detected is low.

Remission

When signs of a disease disappear. This usually follows treatment. The words “complete” and “partial” are sometimes used to further define the term “remission.” Complete remission means that all evidence of the disease is gone. Partial remission means that the disease is markedly improved by treatment, but residual evidence of the disease is present

Refractory CLL

CLL that has not responded to initial treatment. Refractory disease may be disease that is getting worse or staying the same (stable disease).

Refractory CML

CML that has not responded to initial treatment. Refractory disease may be disease that is getting worse or staying the same (stable disease).

Refractory ALL

ALL that has not responded to initial treatment. Refractory disease may be a disease that is getting worse or staying the same even after treatment (stable disease).

Complete Remission

When there is no sign of the disease based on the results of standard tests specific to that disease.

Refractory lymphoma

Lymphoma that has not responded to initial treatment. Refractory disease may be disease that is getting worse or staying the same.

Refractory myeloma

Myeloma that has not responded to initial treatment. Refractory disease may be disease that is getting worse or staying the same.

Drug therapy

Treatment with chemical agents to treat a disease.

Pathologist

A doctor who finds disease by examining body tissue and fluids.

Combination chemotherapy or drug therapy

Using two or more drugs together to fight a disease.

Immune system

A system within the body that works to fight disease and infection.

Partial Remission

When the disease is improved after treatment, but is still present.

Relapse/recurrence

A return of the disease after it has been in remission following therapy.

Diagnose

To detect a disease from a person’s signs, symptoms and test results. The doctor diagnoses a patient.

Diagnosis

To detect a disease from a person’s signs, symptoms and lab test results. The doctor diagnoses a patient.

Hematopathologist

A doctor or scientist who studies the blood cells and blood tissues to identify disease.

Recurrence/Relapse

When disease comes back after it has been successfully treated.

Angiogenesis

The creation of new blood vessels, a critical natural process that occurs in the body both in health and in disease. Normally, the body maintains a balance of angiogenesis regulators. In some disease states, the organs involved may lose control over angiogenesis. In these conditions, new blood vessels either grow too much or not enough.

Richter transformation

In a small number of patients, there is a progression in their disease. In these patients, CLL takes on the characteristics of an aggressive lymphoma. This change is not a second cancer, but a transformation of the CLL cells.

Risk factor

Something that is scientifically linked to a person’s chance of getting a disease. Risk factors can be genetic (inherited), lifestyle related, or environmental.

Signs and symptoms

Changes in the body that show disease. A sign is a change that the doctor sees in an exam or a lab test result. A symptom is a change that a patient can see or feel.

Small lymphocytic lymphoma (SLL)

A disease with symptoms and treatment that are much like CLL. SLL starts in a lymphocyte in a lymph node. CLL starts in a lymphocyte in the marrow.

Combined Modality Therapy

Two or more types of treatment used alternately or at the same time to treat a patient's disease. For example, treating a patient with chemotherapy and involved field radiation therapy is a combined modality therapy.

Immunoglobulin Heavy Chain Variable Region (IgHv) Gene Status

A marker that can distinguish between CLL subtypes (unmutated IgHv and mutated IgHv). People with CLL with unmutated IgHv gene status may have a more progressive form of the disease.

Induction therapy

The initial treatment with chemotherapy (or radiation therapy). The aim of induction therapy is to kill a maximum number of blood cancer cells so as to induce a remission (absence of signs or effects of the disease).

Watch and wait (watchful waiting)

An approach in which a physician closely observes a patient's condition with periodic medical exams and lab tests, without giving drugs or other forms of treatment for the disease in question.

Biomarkers (cancer cell markers)

Chemicals or structures present either on the surface of or within cells or in the serum. They may aid physicians in determining when treatment (and which type of treatment) is needed by identifying disease that will progress more rapidly and/or have a better or worse response to certain treatments. Examples of biomarkers are gene expression, serum protein levels and chromosome abnormalities in cancer cells. No single feature can accurately predict disease progression in a patient; therefore, physicians use a combination of factors to make a diagnosis and a treatment plan.

Lymphoblastic

A term used to describe a type of blood cell disease caused by young or immature lymphocytes or "lymphoblasts." An example is acute lymphoblastic leukemia, which is characterized by the presence of malignant (cancerous) lymphoblasts (immature lymphocytes).

Vaccine therapy

A type of treatment under study for leukemia, lymphoma, or myeloma. This type of vaccine would not prevent the disease. The vaccine would increase the immune system's attack against cancer cells that remain after treatment with drugs.

Zap-70

An abbreviation for the cell protein “zeta-associated protein 70.” A high level of ZAP-70 expression on the cells of patients with B-cell CLL is one of several factors that may predict more progressive disease. Outside of a research laboratory this test is generally not very reliable and should not be used.

Bisphosphonates

A class of drugs, including pamidronate and zoledronic acid, which has been helpful in preventing or minimizing bone loss. Bisphosphonates probably act by preventing cells called "osteoclasts" from dissolving bone. In myeloma, bone thinning (osteoporosis) and fracture are major problems.

Fractionation of the Dose

In order to minimize the significant side effects of total body irradiation conditioning therapy, the dose of radiation required is given in several daily smaller doses rather than one larger dose. This approach has decreased the adverse effects of this treatment.

Radioimmunotherapy

A treatment that uses antibodies to carry a radioactive substance to lymphoma cells to kill them. Radioimmunotherapy such as Zevalin® carries a radioactive substance to the lymphoma cells that then irradiates lymphoma cells locally and selectively. This approach minimizes the effects of radiation on normal tissues.

FMS-like tyrosine kinase 3 gene (FLT3)

An abbreviation for the FMS-like tyrosine kinase 3 gene. FLT3 is expressed on blood forming stem cells and plays a role in cell development. FLT3 mutations can be detected in about one-third of AML patients. These mutations have been identified as part of the AML disease process and may become the basis for new targeted therapies.

Sedimentation Rate

A blood test that measures how quickly red cells (erythrocytes) settle in a test tube in one hour. A sedimentation rate test is done to find out if inflammation is present in the body, to check on the progress of a disease or to see how well a treatment is working. This test is also called a "seed rate" or "erythrocyte sedimentation rate (ESR)."

Extracorporeal Photopheresis

A procedure being studied to treat steroid-refractory graft versus host disease (GVHD). The procedure involves a series of treatments. Blood is removed through a vein, then white cells are isolated and treated with methoxsalen (UVADEX®), a drug that sensitizes the cells to ultraviolet light. UVA rays are used to irradiate the cells, which are then reinfused into the patient.

Extranodal Lymphoma

Lymphoma that has spread outside the lymph nodes to the organs-the thyroid, lung, liver, bone, stomach or central nervous system. Physicians adjust their therapeutic approach if organs outside of lymph nodes are involved. If the brain, liver or bones are involved, for example, the treatment approach is likely to target these areas. If lymphoma is found in any of the organs but not in lymph nodes or multiple lymphatic sites, the disease is called a "solitary extranodal lymphoma."

Gene Expression Profiling

A research method that uses microarray analysis to identify a combination of genes that are turned off or on in response to a specific condition. A set of genes in a blood or tissue sample can be use to monitor the levels of thousands of genes at once. Gene expression profiling is used to help identify cancer subtypes and risk factors as an aid in predicting treatment response and which patients may be at increased risk for relapsed disease. Microarray analysis and related techniques may also lead to the discovery of new treatment targets. (See Microarray Analysis).

Opportunistic Infections

Unusual infections to which patients treated for cancer may be susceptible because of the suppression of their immune system. "Opportunistic" is the term used to describe infections with bacteria, viruses, fungi or protozoa to which individuals with a normal immune system are not susceptible. The infecting organisms take advantage of the opportunity provided by immunodeficiency, especially when coupled with very low white cell counts resulting from therapy or the disease itself.

Haplotype

The tissue type contributed by either the mother or father to his or her offspring. It is implied that it represents the genes on one parental chromosome. When a transplant procedure is between a donor and recipient that are haplotype identical, it means that the tissue type or HLA type of each is identical in respect to mother or father but not identical to the other. In some situations, if the discrepancy is not too great, the transplant may still be possible if the underlying disease makes the risk of partial compatibility warranted. Conditioning of the recipient and lymphocyte depletion of the donor stem cell suspension are steps taken to mitigate the risk of immune cell activation by the tissue type differences.

Hematologist

A doctor who specializes in blood cell diseases.

Complete blood count (CBC)

A series of tests used to measure levels of red cells, white cells, and platelets in the blood, and the appearance of cells on a blood film. The CBC is used diagnose and manage many diseases.

Myeloproliferative Neoplasms (MPNs)

A group of diseases that occur when certain types of blood cells are overproduced. Examples of MPNs are essential thrombocythemia, polycythemia vera and myelofibrosis. Some people with MPNs have abnormal-looking cells in their bone marrow that are similar to MDS cells.

Amyloid

In myeloma, an abnormal protein made by malignant plasma cells. An amyloid deposit develops when parts of the immunoglobulin molecule, referred to as "light chains," deposit in tissues. In the type of amyloid that occurs in myeloma or closely related diseases, organ failure can occur as a result of amyloid deposits in the heart, gastrointestinal tract, kidney, nerves, and other systems.

Immunotherapy

A treatment that uses the body’s immune system to treat diseases. Such therapies include - Monoclonal antibody therapy: a type of drug using antibodies designed to attack specific parts of the cancer cells - Radioimmunotherapy: a type of drug that uses radioactive substances and antibodies to attack cancer cells - Vaccine therapy: drugs used to stimulate the immune system to fight cancer cells.

Lactate Dehydrogenase (LDH)

An enzyme present in all normal and abnormal cells. It is released from cells into the blood and is present in normal amounts in the liquid portion of blood (the plasma). When blood is collected and allowed to clot, the fluid portion is called the "serum." Many chemicals are measured in the serum, including LDH. Normal serum contains low levels of LDH. The level may be elevated in many diseases, such as hepatitis and various cancers. Changes in LDH are nonspecific, but when LDH is elevated in the presence of certain cancers, the change may reflect the extent of the tumor and the rapidity of tumor growth. LDH monitoring is used in some cases along with other measures to plan the intensity of therapy.

The Impact of Minimal Residual Disease in Acute Lymphoblastic Leukemia

June 16, 2017

Presentation Click Here


  Topics Covered We invite you to learn more about: ​Current treatment options for patients living with ALL The impact of minimal residual disease (MRD) Clinical trials and emerging therapies for ALL treatment The importance of open communication with your healthcare team to promote a better quality of life
  Speaker Daniel J. DeAngelo, M.D., Ph.D.
Adult Leukemia Pr ...

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Castleman Disease

Disclaimer: These resources are regularly reviewed to ensure that links still work correctly and the resources listed continue to be helpful to our visitors. If you find that a link isn't working or information is incorrect or if you'd like to have your own organization listed here, please email infocenter@lls.org. Because we want to be sure that our visitors find the most relevant resources, we encourage you to visit the organization's website for more detailed information. ...

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Related Diseases

Myeloma shares some similar features and symptoms with other blood disorders, including: Monoclonal gammopathy Waldenström macroglobulinemia (WM) Primary amyloidosis Heavy chain disease Light chain deposition disease (LCDD) Plasma cell leukemia (PCL) POEMS syndrome  
Monoclonal Gammopathy This condition, also called “benign monoclonal gammopathy,” “monoclonal gammopathy of unknown or undetermined significance” (MGUS) and other names, ...

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Disease Complications

Myeloma can lead to other mild to serious health complications and side effects: Fatigue One of the most troublesome complaints reported by myeloma patients is fatigue. Fatigue can be caused by many factors, including disease-related anemia, treatment and medication side effects, physical immobility, sleep disturbance, nutritional deficits, depression, stress and anxiety. Each individual’s fatigue should be evaluated to identify other possible causes that are unrelated to ...

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Disease Complications

Thrombosis (Blood Clots) Abnormalities in the platelets increase a patient’s risk of developing blood that is too thick and blood clots inside a blood vessel. Blood clots can block the flow of blood in the vessel, depriving tissues of normal blood flow and oxygen. Blood clots can cause stroke, heart attack or pulmonary embolism (blockage of an artery in the lungs). Blood clots occur in about 30 percent of patients even before polycythemia vera (PV) is diagnosed.
  En ...

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Glossary Results

Minimal Residual Disease (MRD)

The small amounts of cancer cells that may remain after treatment. These cells are only identified by sensitive molecular techniques.

Relapsed Disease

Disease that initially responded to therapy but has begun to progress.

Refractory Disease

A disease that does not go away or improve much after initial treatment.

Graft-Versus-Host Disease (GVHD)

A disease that happens when the donor cells (“the graft”) attack the cells of the patient (“the host”). Most often this disease attacks a patient’s skin, liver, and the stomach and gastrointestinal tract.

Disease subtype

A term used to describe a form of leukemia, lymphoma, myeloma, myelodysplastic syndromes and other diseases. The disease subtype is often important in determining how to treat the patient.

Veno-occlusive disease (VOD)

A disease that may be a complication following high-dose chemotherapy and/or radiation, in which the blood vessels that carry blood through the liver, swell and become clogged.

Nonsecretory Disease

In a small proportion of patients with myeloma, no abnormal protein can be detected.

Oligosecretory Disease

In a small proportion of patients with myeloma, the level of abnormal protein that is detected is low.

Remission

When signs of a disease disappear. This usually follows treatment. The words “complete” and “partial” are sometimes used to further define the term “remission.” Complete remission means that all evidence of the disease is gone. Partial remission means that the disease is markedly improved by treatment, but residual evidence of the disease is present

Refractory CLL

CLL that has not responded to initial treatment. Refractory disease may be disease that is getting worse or staying the same (stable disease).

Refractory CML

CML that has not responded to initial treatment. Refractory disease may be disease that is getting worse or staying the same (stable disease).

Refractory ALL

ALL that has not responded to initial treatment. Refractory disease may be a disease that is getting worse or staying the same even after treatment (stable disease).

Complete Remission

When there is no sign of the disease based on the results of standard tests specific to that disease.

Refractory lymphoma

Lymphoma that has not responded to initial treatment. Refractory disease may be disease that is getting worse or staying the same.

Refractory myeloma

Myeloma that has not responded to initial treatment. Refractory disease may be disease that is getting worse or staying the same.

Drug therapy

Treatment with chemical agents to treat a disease.

Pathologist

A doctor who finds disease by examining body tissue and fluids.

Combination chemotherapy or drug therapy

Using two or more drugs together to fight a disease.

Immune system

A system within the body that works to fight disease and infection.

Partial Remission

When the disease is improved after treatment, but is still present.

Relapse/recurrence

A return of the disease after it has been in remission following therapy.

Diagnose

To detect a disease from a person’s signs, symptoms and test results. The doctor diagnoses a patient.

Diagnosis

To detect a disease from a person’s signs, symptoms and lab test results. The doctor diagnoses a patient.

Hematopathologist

A doctor or scientist who studies the blood cells and blood tissues to identify disease.

Recurrence/Relapse

When disease comes back after it has been successfully treated.

Angiogenesis

The creation of new blood vessels, a critical natural process that occurs in the body both in health and in disease. Normally, the body maintains a balance of angiogenesis regulators. In some disease states, the organs involved may lose control over angiogenesis. In these conditions, new blood vessels either grow too much or not enough.

Richter transformation

In a small number of patients, there is a progression in their disease. In these patients, CLL takes on the characteristics of an aggressive lymphoma. This change is not a second cancer, but a transformation of the CLL cells.

Risk factor

Something that is scientifically linked to a person’s chance of getting a disease. Risk factors can be genetic (inherited), lifestyle related, or environmental.

Signs and symptoms

Changes in the body that show disease. A sign is a change that the doctor sees in an exam or a lab test result. A symptom is a change that a patient can see or feel.

Small lymphocytic lymphoma (SLL)

A disease with symptoms and treatment that are much like CLL. SLL starts in a lymphocyte in a lymph node. CLL starts in a lymphocyte in the marrow.

Combined Modality Therapy

Two or more types of treatment used alternately or at the same time to treat a patient's disease. For example, treating a patient with chemotherapy and involved field radiation therapy is a combined modality therapy.

Immunoglobulin Heavy Chain Variable Region (IgHv) Gene Status

A marker that can distinguish between CLL subtypes (unmutated IgHv and mutated IgHv). People with CLL with unmutated IgHv gene status may have a more progressive form of the disease.

Induction therapy

The initial treatment with chemotherapy (or radiation therapy). The aim of induction therapy is to kill a maximum number of blood cancer cells so as to induce a remission (absence of signs or effects of the disease).

Watch and wait (watchful waiting)

An approach in which a physician closely observes a patient's condition with periodic medical exams and lab tests, without giving drugs or other forms of treatment for the disease in question.

Biomarkers (cancer cell markers)

Chemicals or structures present either on the surface of or within cells or in the serum. They may aid physicians in determining when treatment (and which type of treatment) is needed by identifying disease that will progress more rapidly and/or have a better or worse response to certain treatments. Examples of biomarkers are gene expression, serum protein levels and chromosome abnormalities in cancer cells. No single feature can accurately predict disease progression in a patient; therefore, physicians use a combination of factors to make a diagnosis and a treatment plan.

Lymphoblastic

A term used to describe a type of blood cell disease caused by young or immature lymphocytes or "lymphoblasts." An example is acute lymphoblastic leukemia, which is characterized by the presence of malignant (cancerous) lymphoblasts (immature lymphocytes).

Vaccine therapy

A type of treatment under study for leukemia, lymphoma, or myeloma. This type of vaccine would not prevent the disease. The vaccine would increase the immune system's attack against cancer cells that remain after treatment with drugs.

Zap-70

An abbreviation for the cell protein “zeta-associated protein 70.” A high level of ZAP-70 expression on the cells of patients with B-cell CLL is one of several factors that may predict more progressive disease. Outside of a research laboratory this test is generally not very reliable and should not be used.

Bisphosphonates

A class of drugs, including pamidronate and zoledronic acid, which has been helpful in preventing or minimizing bone loss. Bisphosphonates probably act by preventing cells called "osteoclasts" from dissolving bone. In myeloma, bone thinning (osteoporosis) and fracture are major problems.

Fractionation of the Dose

In order to minimize the significant side effects of total body irradiation conditioning therapy, the dose of radiation required is given in several daily smaller doses rather than one larger dose. This approach has decreased the adverse effects of this treatment.

Radioimmunotherapy

A treatment that uses antibodies to carry a radioactive substance to lymphoma cells to kill them. Radioimmunotherapy such as Zevalin® carries a radioactive substance to the lymphoma cells that then irradiates lymphoma cells locally and selectively. This approach minimizes the effects of radiation on normal tissues.

FMS-like tyrosine kinase 3 gene (FLT3)

An abbreviation for the FMS-like tyrosine kinase 3 gene. FLT3 is expressed on blood forming stem cells and plays a role in cell development. FLT3 mutations can be detected in about one-third of AML patients. These mutations have been identified as part of the AML disease process and may become the basis for new targeted therapies.

Sedimentation Rate

A blood test that measures how quickly red cells (erythrocytes) settle in a test tube in one hour. A sedimentation rate test is done to find out if inflammation is present in the body, to check on the progress of a disease or to see how well a treatment is working. This test is also called a "seed rate" or "erythrocyte sedimentation rate (ESR)."

Extracorporeal Photopheresis

A procedure being studied to treat steroid-refractory graft versus host disease (GVHD). The procedure involves a series of treatments. Blood is removed through a vein, then white cells are isolated and treated with methoxsalen (UVADEX®), a drug that sensitizes the cells to ultraviolet light. UVA rays are used to irradiate the cells, which are then reinfused into the patient.

Extranodal Lymphoma

Lymphoma that has spread outside the lymph nodes to the organs-the thyroid, lung, liver, bone, stomach or central nervous system. Physicians adjust their therapeutic approach if organs outside of lymph nodes are involved. If the brain, liver or bones are involved, for example, the treatment approach is likely to target these areas. If lymphoma is found in any of the organs but not in lymph nodes or multiple lymphatic sites, the disease is called a "solitary extranodal lymphoma."

Gene Expression Profiling

A research method that uses microarray analysis to identify a combination of genes that are turned off or on in response to a specific condition. A set of genes in a blood or tissue sample can be use to monitor the levels of thousands of genes at once. Gene expression profiling is used to help identify cancer subtypes and risk factors as an aid in predicting treatment response and which patients may be at increased risk for relapsed disease. Microarray analysis and related techniques may also lead to the discovery of new treatment targets. (See Microarray Analysis).

Opportunistic Infections

Unusual infections to which patients treated for cancer may be susceptible because of the suppression of their immune system. "Opportunistic" is the term used to describe infections with bacteria, viruses, fungi or protozoa to which individuals with a normal immune system are not susceptible. The infecting organisms take advantage of the opportunity provided by immunodeficiency, especially when coupled with very low white cell counts resulting from therapy or the disease itself.

Haplotype

The tissue type contributed by either the mother or father to his or her offspring. It is implied that it represents the genes on one parental chromosome. When a transplant procedure is between a donor and recipient that are haplotype identical, it means that the tissue type or HLA type of each is identical in respect to mother or father but not identical to the other. In some situations, if the discrepancy is not too great, the transplant may still be possible if the underlying disease makes the risk of partial compatibility warranted. Conditioning of the recipient and lymphocyte depletion of the donor stem cell suspension are steps taken to mitigate the risk of immune cell activation by the tissue type differences.

Hematologist

A doctor who specializes in blood cell diseases.

Complete blood count (CBC)

A series of tests used to measure levels of red cells, white cells, and platelets in the blood, and the appearance of cells on a blood film. The CBC is used diagnose and manage many diseases.

Myeloproliferative Neoplasms (MPNs)

A group of diseases that occur when certain types of blood cells are overproduced. Examples of MPNs are essential thrombocythemia, polycythemia vera and myelofibrosis. Some people with MPNs have abnormal-looking cells in their bone marrow that are similar to MDS cells.

Amyloid

In myeloma, an abnormal protein made by malignant plasma cells. An amyloid deposit develops when parts of the immunoglobulin molecule, referred to as "light chains," deposit in tissues. In the type of amyloid that occurs in myeloma or closely related diseases, organ failure can occur as a result of amyloid deposits in the heart, gastrointestinal tract, kidney, nerves, and other systems.

Immunotherapy

A treatment that uses the body’s immune system to treat diseases. Such therapies include - Monoclonal antibody therapy: a type of drug using antibodies designed to attack specific parts of the cancer cells - Radioimmunotherapy: a type of drug that uses radioactive substances and antibodies to attack cancer cells - Vaccine therapy: drugs used to stimulate the immune system to fight cancer cells.

Lactate Dehydrogenase (LDH)

An enzyme present in all normal and abnormal cells. It is released from cells into the blood and is present in normal amounts in the liquid portion of blood (the plasma). When blood is collected and allowed to clot, the fluid portion is called the "serum." Many chemicals are measured in the serum, including LDH. Normal serum contains low levels of LDH. The level may be elevated in many diseases, such as hepatitis and various cancers. Changes in LDH are nonspecific, but when LDH is elevated in the presence of certain cancers, the change may reflect the extent of the tumor and the rapidity of tumor growth. LDH monitoring is used in some cases along with other measures to plan the intensity of therapy.