The first step in the successful treatment of a patient with acute myeloid leukemia (AML) is the attainment of a complete remission (CR), which is characterized by:
●Normal values for absolute neutrophil count (>1000/microL) and platelet count (>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.
●A bone marrow aspiration revealing normal maturation of all cellular components (ie, erythroid, granulocytic, and megakaryocytic series). There is no requirement for bone marrow cellularity.
●Less than 5 percent of blast cells present in the bone marrow, and none with 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.