Complete remission is a vital first step on the way to being cured of acute myeloid leukaemia [AML]. After the first course of chemotherapy, your wife’s doctors will have been checking her blood counts at intervals to spot when there are signs of her own marrow recovering from the chemotherapy.

When her neutrophil count is over 1 and her platelet count is over 100 they will need to look at her marrow to see what effect the chemotherapy has had on the factory that makes all her blood cells. They are hoping that the marrow has recovered well with signs of all the normal marrow cells returning in normal numbers. They are also looking out for any leukaemic cells left over after the chemotherapy. These are called blasts.

A ‘blast’ is an early or immature blood cell.usually found in the bone marrow. In leukaemia, the marrow clogs up with these immature cells. Sometimes they may also spill out into the blood. These blast cells can be identified and counted. This helps with the diagnosis,  and in evaluating the effect of therapy. Acute leukaemia is defined as having > 20% blasts in the marrow and  when somebody is in complete remission it means that their blood counts have recovered, they have a marrow with normal amounts of all the different types of normal marrow cells and that there are less than 5% blasts in their marrow.

It is important to stress that it is only a first step and does not yet mean that she is cured. It is however a good start. Up to 20% of patients fail to go into remission straight away and the outlook for this group is much worse.