Treatment Desired Outcome

The primary objective in treating patients with acute leukemia is to achieve a continuous complete remission (CCR). Remission is defined as the absence of all clinical evidence of leukemia with the restoration of normal hematopoiesis. For both ALL and AML, remission induction is achieved with the use of highly myelosuppressive chemotherapy that initially induces a state of bone marrow aplasia as the leukemic cells die, followed by a slow return and proliferation of normal cells.12 Following this period, hematopoiesis is restored. Failure to achieve remission in the first 7 to 14 days of therapy is highly predictive of later disease recurrence. This again represents the growing importance of MRD in prognosis and treatment.

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