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	<title>Cancer Treatment Today &#187; Tests</title>
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	<description>Knowledge is Power</description>
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		<title>Criteria for Remission in AML &#8211; pro</title>
		<link>http://cancertreatmenttoday.org/criteria-for-remission-in-aml-pro/</link>
		<comments>http://cancertreatmenttoday.org/criteria-for-remission-in-aml-pro/#comments</comments>
		<pubDate>Fri, 03 Aug 2012 01:20:39 +0000</pubDate>
		<dc:creator>M Levin, MD</dc:creator>
				<category><![CDATA[Acute Myelogenous Leukemia]]></category>
		<category><![CDATA[Professional]]></category>
		<category><![CDATA[Tests]]></category>

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		<description><![CDATA[International Working Group has enunciated criteria for defining a remission for AML Normal values for absolute neutrophil count (&#62;1000/microL) and platelet count (&#62;100,000/microL), and independence from red cell transfusion. A bone marrow biopsy that reveals no clusters or collections of blast cells. Extramedullary leukemia (eg, central nervous system or soft tissue involvement) must be absent. [...]]]></description>
			<content:encoded><![CDATA[<p>International Working Group has enunciated criteria for defining a remission for AML</p>
<ul>
<li>Normal values for absolute neutrophil count (&gt;1000/microL) and platelet count (&gt;100,000/microL), and independence from red cell transfusion.</li>
<li>A bone marrow biopsy that reveals no clusters or collections of blast cells. Extramedullary leukemia (eg, <a title="Powered by Text-Enhance" href="http://www.uptodate.com/contents/remission-criteria-in-acute-myeloid-leukemia-and-monitoring-for-residual-disease#">central nervous system</a> or soft tissue involvement) must be absent.</li>
<li>A bone marrow aspiration reveals normal maturation of all cellular components (ie, erythrocytic, granulocytic, and megakaryocytic series). There is no requirement for bone marrow cellularity.</li>
<li>Less than 5 percent blast cells are present in the bone marrow, and none can have a leukemic phenotype (eg, Auer rods). The persistence of dysplasia is worrisome as an indicator of residual AML but has not been validated as a criterion for remission status.</li>
<li>The absence of a previously detected clonal cytogenetic abnormality (ie, complete cytogenetic remission, CRc) confirms the morphologic diagnosis of CR but is not currently a required criterion. However, conversion from an abnormal to a normal karyotype at the time of first CR is an important prognostic indicator, supporting the use of CRc as a criterion for CR in AML.</li>
</ul>
<p>Some patients may fulfill all of the above criteria for CR but may not recover normal peripheral blood counts. These are denoted as CRi, or CR with insufficient hematological recovery (platelets or neutrophils). CRp describes a subset of patients with CRi, wherein patients fulfill all criteria for CR except that <a title="Powered by Text-Enhance" href="http://www.uptodate.com/contents/remission-criteria-in-acute-myeloid-leukemia-and-monitoring-for-residual-disease#">platelet counts</a> are &lt;100,000/microL. Lack of full recovery of counts is of significant concern as it may presage relapse.The survival and relapse rates for patients with CRp appear to be worse than those with a CR, but better than those with a partial remission (PR).</p>
<ul>
<li><a href="http://www.uptodate.com/contents/remission-criteria-in-acute-myeloid-leukemia-and-monitoring-for-residual-disease/abstract/1">Döhner H, Estey EH, Amadori S, et al. Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNet. Blood 2010; 115:453.</a></li>
<li><a href="http://www.uptodate.com/contents/remission-criteria-in-acute-myeloid-leukemia-and-monitoring-for-residual-disease/abstract/2">Cheson BD, Bennett JM, Kopecky KJ, et al. Revised recommendations of the International Working Group for Diagnosis, Standardization of Response Criteria, Treatment Outcomes, and Reporting Standards for Therapeutic Trials in Acute Myeloid Leukemia. J Clin Oncol 2003; 21:4642.</a></li>
<li><a href="http://www.uptodate.com/contents/remission-criteria-in-acute-myeloid-leukemia-and-monitoring-for-residual-disease/abstract/3">de Greef GE, van Putten WL, Boogaerts M, et al. Criteria for defining a complete remission in acute myeloid leukaemia revisited. An analysis of patients treated in HOVON-SAKK co-operative group studies. Br J Haematol 2005; 128:184.</a></li>
<li><a href="http://www.uptodate.com/contents/remission-criteria-in-acute-myeloid-leukemia-and-monitoring-for-residual-disease/abstract/4">Marcucci G, Mrózek K, Ruppert AS, et al. Abnormal cytogenetics at date of morphologic complete remission predicts short overall and disease-free survival, and higher relapse rate in adult acute myeloid leukemia: results from cancer and leukemia group B study 8461. J Clin Oncol 2004; 22:2410.</a></li>
<li><a href="http://www.uptodate.com/contents/remission-criteria-in-acute-myeloid-leukemia-and-monitoring-for-residual-disease/abstract/5">Chen Y, Cortes J, Estrov Z, et al. Persistence of cytogenetic abnormalities at complete remission after induction in patients with acute myeloid leukemia: prognostic significance and the potential role of allogeneic stem-cell transplantation. J Clin Oncol 2011; 29:2507.</a></li>
<li><a href="http://www.uptodate.com/contents/remission-criteria-in-acute-myeloid-leukemia-and-monitoring-for-residual-disease/abstract/6">Appelbaum FR, Rosenblum D, Arceci RJ, et al. End points to establish the efficacy of new agents in the treatment of acute leukemia. Blood 2007; 109:1810.</a></li>
<li><a href="http://www.uptodate.com/contents/remission-criteria-in-acute-myeloid-leukemia-and-monitoring-for-residual-disease/abstract/7">Walter RB, Kantarjian HM, Huang X, et al. Effect of complete remission and responses less than complete remission on survival in acute myeloid leukemia: a combined Eastern Cooperative Oncology Group, Southwest Oncology Group, and M. D. Anderson Cancer Center Study. J Clin Oncol 2010; 28:1766.</a></li>
</ul>
<p>Read the Layperson version <strong><span style="color: #ff0000;"><a title="Criteria for Remission in AML" href="http://cancertreatmenttoday.org/criteria-for-remission-in-aml/"><span style="color: #ff0000;">here</span></a>.</span></strong></p>
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