PMID: 8611718May 1, 1996Paper

Routine bone marrow exam during first remission of acute myeloid leukemia.

Blood
E H Estey, S Pierce

Abstract

To detect relapse acute myeloid leukemia (AML) treatment protocols have called for bone marrow exams every 2 to 4 months in remission. To investigate the effect of replacing this policy with one calling for marrows only when blood count is abnormal (platelets < 100,000, neutrophils < 1,000, circulating blasts > 0%, unrelated to prior chemotherapy), we reviewed the records of all 444 patients with AML whose disease recurred ( > or = 5% marrow blasts unrelated to prior chemotherapy) for the first time between 1980 and 1995. The 375 patients with adequate follow-up were classified as (1) simultaneous--blood count abnormal when relapse noted without a normal marrow intervening between first abnormal count and relapse, 289 patients (77% of 375), (2) marrow first--blood count normal when relapse noted, 60 patients (16%), or (3) blood first--a normal marrow intervened between first abnormal blood count and relapse, 26 patients (7%). Interval between marrow exams and blood counts did not differ in the three groups (a 25-patient sample of the 289 patient simultaneous group was analyzed as representative of this group) with marrows done at a median of once monthly and blood counts at a median of once weekly from complete remission (CR) d...Continue Reading

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