Morphologic Cr

Morphologic CR without complete recovery of platelet count is not considered a category of CR in AML patients.1 The same is true for ALL patients. Time to platelet recovery seems to predict outcome of patients with de novo ALL who have achieved CR.5 In one study, patients who did not achieve platelet recovery by day 48 had a significantly worse outcome than those who achieved platelet recovery by day 12. Therefore, in ALL, morphologic CR without platelet count recovery (>100 X 109/L) should not be regarded as CR.

Finally, the definition of CR in AML was previously associated with a requirement for a 4-week duration of persistent remission to qualify as a CR. However, in ALL, postremission therapy is administered without any delays, and therefore the definition of CR should not be time dependent; retrospective designation of CR based on subsequent clinical course is not recommended. This correlates with the recently revised definition of CR in AML.1

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