What does it mean to be in remission with AML? Let's first talk about the basics. Being in remission with AML is not the same as being cured of AML. Remission can be in part or in full. You may still have detectable AML but have fewer cancer cells present. Every patient wonders how long that remission will last, but there is no simple formula and every patient is different. It can depend on the type of AML treatment you receive, the genetics of your AML and other health factors. 

Levels of Response to Treatment: 

Complete Remission

This means that there are no signs of leukemia after treatment. Blood counts have returned to normal and there are fewer than 5% immature leukemia cells (blasts) in the bone marrow. The patient also has an improvement in blood counts as evidenced by an absolute neutrophil count (ANC) >1000 cells/μL and platelet count > 100,000/μL, with no need for red blood cell transfusions, and the absence of any tumors formed outside of the bone marrow. Being in remission doesn’t necessarily mean a cure. A remission may be long-lasting (permanent), but remission may also be short-term (temporary). 

Complete Remission with Incomplete Hematologic Recovery

This means that all of the criteria for complete remission are achieved except that the absolute neutrophil count (ANC) is <1000 cells/μL or the platelet count is <100,000/μL in the blood. 

Minimal Residual Disease (MRD)

MRD refers to the small number of cancer cells that remain in the body after treatment. The number of remaining cells may be so small that they do not cause any physical signs or symptoms and often cannot even be detected through traditional methods, such as viewing cells under a microscope. An MRD positive test result means that the remaining disease was detected. A negative result means that the remaining disease was not detected. Detecting MRD may indicate that the treatment was not completely effective or that the treatment was incomplete.

Relapsed (Recurrent) AML

This means that the AML has returned after a period of remission. Blood counts may be abnormal again. A discussion about treatment options to try to get the AML back into remission may be warranted at this time. 

Refractory AML

This means that the AML has not gone away and has not responded to 2 cycles of chemotherapy. Patients who are progressing while on therapy are considered "refractory" to their treatment. 

Facts about AML Relapse 

• Despite major advancements in AML drug therapy over the past 5 years, relapse affects about 50% percent of all AML patients 
• Relapse may occur several months to years after the initial remission, however, the majority of relapses occur within 2 years of initial treatment
• The signs and symptoms of relapse are similar to signs and symptoms that were present during the original disease onset 
• A relapse diagnosis will be obtained in a similar fashion as the original diagnosis

For more information on what to expect during AML relapse click here.