VALUE OF BONE-MARROW FOLLOW-UP EXAMINATIO N ON DAY-A AND DAY-17 OF THE FIRST INDUCTION COURSE IN ACUTE MYELOGENOUS LEUKEMIA (AML)

Bone marrow examination yields valuable diagnostic information for eva luation of treatment efficacy in acute myelogenous leukemia (AML) pati ents. However, the ideal timing of this procedure remains to be define d. Usually the first follow-up examination is performed on day 17 of t he induction course. Since an earlier analysis might be helpful in dec iding on the subsequent treatment strategy, we explored whether an exa mination on day 8 might be equivalent, in particular in terms of quali ty of the specimen, as compared with that on day 17. In 10 AML patient s undergoing the same induction treatment, bone marrow aspirates were examined prospectively at diagnosis (day 0), immediately after termina tion (day 8) and on day 17 of the first treatment course. We found tha t the number of cells not classifiable due to artifacts, as well as th e otherwise non-evaluable cells, did not differ significantly in aspir ates obtained on day 8 as compared with those on day 17. The number of leukemic cells decreased significantly from day 0 to day 8, whereas n o change was noted between days 8 and 17. We conclude that a marrow ex amination on day 8 is not more prone to misinterpretation due to artif acts than our standard examination on day 17. Thus, an early marrow an alysis immediately after completion of the first induction cycle might be a helpful tool in evaluating the course of AML.