Definition Of Remission

The importance in achieving a consensus on the definition of remission is to allow comparison of results from an assortment of studies and different institutions to provide the basis on which to make decisions about the care of patients. Consensus, as such, is required, but its achievement is compounded by the quality of the bone marrow specimen and the experience of the pathologist evaluating it. A morphologic complete remission (CR) is defined as having a neutrophil count >1.0 X 109/L, platelet count >100 X 109/L, normal bone marrow cellularity with trilineage hematopoiesis, with <5% blasts and resolution of all extramedullary disease. 1Note that hemoglobin concentration or hematocrit are not included when evaluating remission status, but the patient has to be transfusion independent. Partial remission (PR) is not used for studies in which the objective is cure, but is used for phase I and II studies, conducted in patients with refractory or relapsed disease. In such cases, the aim is to record any significant activity. PR is then defined as >5% but <20% blasts.

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