🌀Mood: Hopeful, Reflective, Grounded, Grateful, Cautiously Optimistic

It’s Day 70 after my stem cell transplant, and on Wednesday I will have another bone marrow biopsy.

Typically, these milestone tests happen closer to Day 90 after transplant. But my oncologist wanted mine done earlier, around Day 55, to get a sooner look at how my body — and the myeloma — are responding to treatment.

I realized that this is probably a good time to explain what this biopsy actually means — because this test is about much more than simply “good news” or “bad news.”

There are really two things happening right now.

The first is the cancer story.

The second is the recovery story.

And both can be true at the same time.

A bone marrow biopsy is one of the main ways my oncology team measures how well my treatment worked. Multiple myeloma starts in the plasma cells inside the bone marrow, so this test lets them look directly at the “factory” where my blood cells are made.

The procedure itself is not something I’m particularly looking forward to, but thankfully I will be sedated for it. Once it’s done, the waiting begins. Results can take about 7–10 days because they are looking at several different things in the sample.

What are they looking for?

They are trying to answer questions like:

• How much did the myeloma respond to treatment?
• Are there still cancerous plasma cells in my bone marrow?
• Am I in remission?
• How deep was the response?
• Am I MRD-negative?

MRD stands for Minimal Residual Disease.

In very simple terms, MRD testing looks for tiny traces of myeloma cells that are too small to see under a regular microscope. The technology is incredibly sensitive — in some cases, able to detect as little as 1 myeloma cell among 1 million healthy cells.

If someone is MRD-negative, it means the test could not find detectable myeloma cells at that level of sensitivity. That is considered a very encouraging result in multiple myeloma treatment.

But this is also where I think it’s important to explain something that many people may not realize:

Remission in multiple myeloma is not the same as remission in many other cancers.

For many cancers, people hear the word remission and think:
“She’s done.”
“She beat it.”
“Life goes back to normal.”

Multiple myeloma doesn’t quite work that way.

Myeloma is considered a chronic blood cancer. The goal is to get the disease as low as possible, control it for as long as possible, and continue treatment to keep it there. Even if I receive wonderful news from this biopsy, it does not mean I am “finished.” It means this major phase of treatment worked.

And honestly, that would still be incredible news.

But while the biopsy is measuring the cancer response, my body is also recovering from something entirely different: the stem cell transplant itself.

That recovery is still very real.

The high-dose melphalan chemotherapy essentially wiped out my immune system before my stem cells were given back to me. So even if my biopsy results are excellent, I am still highly immunocompromised right now.

That part doesn’t magically disappear with a good biopsy result.

My immune system is still rebuilding.
My body is still healing.
My stamina is still recovering.
I still have to be extremely careful about infection exposure — especially with food safety and being around large groups of people — for many months ahead.

So when these results come back, there may be two truths sitting side-by-side:

The cancer may be responding beautifully.

And I may still be very much in recovery.

Two things can be true.

As I head into this week, I feel hopeful. I feel grateful. I also feel realistic about what this moment means — and what it doesn’t mean.

This biopsy is not the finish line.
It’s a milestone.

And in my heart, I truly believe God has already carried me through to remission.

Now we wait for the results that will help tell the rest of the story.