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Questions and answers

What is remission?

The word “remission” brings hope. But it is important to know exactly what it means.

Last updated: ~2 min read
The marrow fills with healthy cells
Figure 1.The marrow fills with healthy cells

01Short answer

Remission is the reduction or disappearance of signs of leukemia after treatment. In complete remission, blasts in the bone marrow are within the normal range (usually under 5%), blood counts recover and no signs of disease are seen. An even deeper level is MRD-negative remission: even very sensitive tests find no leukemia cells. Remission is an important milestone but not always the end of treatment: further treatment and follow-up are needed to keep the disease from returning.

02Simple explanation

Remission means the disease cannot be seen in tests.

It does not mean “not a single leukemia cell is left”; sometimes a very small number may remain.

03Scientific explanation

In acute leukemias, complete remission (CR) is defined by marrow blasts under 5%, no blasts in the blood, and recovery of neutrophils and platelets.

MRD is measured by flow cytometry, PCR or NGS; being MRD-negative is linked with a better outlook but is not a guarantee on its own.

04What happens in the body?

Kinds of remission

Complete remission: all criteria are met. Partial remission: the disease has shrunk but not gone. In chronic leukemias terms such as “haematological”, “cytogenetic” and “molecular” response are used.

How it is checked

Blood tests, bone marrow aspiration and genetic tests are done. The doctor compares results and tells you how deep the response is.

The microscope: only a few cells remain
Figure 2.The microscope: only a few cells remain

After remission

In acute leukemias consolidation courses usually follow, sometimes a transplant. Then long-term follow-up begins: regular blood tests and clinic visits.

Remission, a new morning
Figure 3.Remission, a new morning

05How remission is confirmed

Four main measures the doctor checks.

A marrow sample — A small sample of bone marrow is taken.1A marrow sampleA small sample of bone marrow is taken.
Counting blasts — The share of blasts is measured.2Counting blastsThe share of blasts is measured.
Blood recovers — Neutrophils and platelets return to normal.3Blood recoversNeutrophils and platelets return to normal.
An MRD test — A sensitive test looks for remaining cells.4An MRD testA sensitive test looks for remaining cells.
An important milestoneRemission shows the treatment is working.
Follow-up continuesPlan the next stage with your doctor.

06Key points at a glance

TopicIn brief
Kinds of remissionComplete remission: all criteria are met. Partial remission: the disease has shrunk but not gone. In chronic leukemias terms such as “haematological”, “cytogenetic” and “molecular” response are used.
How it is checkedBlood tests, bone marrow aspiration and genetic tests are done. The doctor compares results and tells you how deep the response is.
After remissionIn acute leukemias consolidation courses usually follow, sometimes a transplant. Then long-term follow-up begins: regular blood tests and clinic visits.

07Key terms

Complete remission
Leukemia not seen by all main criteria.
MRD-negative
Sensitive tests find no leukemia cells.
Consolidation
Treatment after remission that strengthens it.

08Key points

  • Remission means the disease is not seen in tests.
  • There is complete and partial remission.
  • MRD shows a deeper response.
  • Treatment may continue after remission.

09Frequently asked questions

Should I feel well once in remission?

The body needs time to recover; tiredness can last for a while.

How long does remission last?

It depends on the type and genetics; your doctor will explain your situation.

What does MRD-positive mean?

A small number of cells was found; the doctor may take this into account and adjust the plan.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Should I feel well once in remission?

  2. How long does remission last?

  3. What does MRD-positive mean?

My questions

12Sources

  1. National Cancer Institute (NCI). NCI Dictionary of Cancer Terms: remission
  2. National Cancer Institute (NCI). Adult Acute Myeloid Leukemia Treatment (PDQ®) – Patient Version
  3. National Cancer Institute (NCI). Adult Acute Lymphoblastic Leukemia Treatment (PDQ®) – Patient Version
  4. National Cancer Institute (NCI). Follow-Up Medical Care
  5. MedlinePlus (U.S. National Library of Medicine). Bone marrow aspiration
  6. National Cancer Institute (NCI). Common Cancer Myths and Misconceptions
  7. MedlinePlus (U.S. National Library of Medicine). How to Understand Your Lab Results
  8. World Health Organization (WHO). Sepsis — fact sheet
  9. National Cancer Institute (NCI). Survivorship: During and After Treatment
  10. NHS (UK). Acute lymphoblastic leukaemia
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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