After treatment and remission

What is remission?

Hearing “you are in remission” is one of the most longed-for moments on the leukemia journey. It means that treatment is working and the blood is filling up with healthy cells again. But what exactly does remission mean, is it the same as being cured, and what comes next? This topic explains in plain language the types of remission, how remission is defined and how to look after yourself at this stage.

Last updated: 3 October 2026~6 min read

Translucent tissue resembling bone marrow on a dark navy background, full of healthy red and white blood cells under a warm glow like the light of dawn. — **Figure 1.**Concept: in remission, the bone marrow fills with healthy cells again.

01Short answer

Remission means that the signs of leukemia have decreased or disappeared after treatment. In acute leukemias, complete remission means fewer than 5% blast cells in the bone marrow, no blasts in the blood and recovered blood counts. In chronic leukemias, response is usually assessed at the hematologic, cytogenetic and molecular levels. Remission is a big and joyful step, but it is not yet the end of the road: to stop hidden cells from coming back, further treatment (consolidation, maintenance or a transplant) and regular follow-up are often needed. The depth of remission is shown by measurable residual disease (MRD) tests. Only your hematology team can explain what remission means in your own situation.

02Simple explanation

At diagnosis, the bone marrow is packed with leukemia cells and there is no room left for healthy cells. When treatment destroys these cells, the marrow starts making normal blood cells again. When tests no longer show traces of leukemia, this is called remission.

Complete remission means that under an ordinary microscope almost no leukemia cells can be seen in the marrow and the blood counts have returned to normal. Sometimes the counts have not fully recovered yet; doctors note this separately.

Partial remission shows that the leukemia has shrunk a lot but has not gone completely. It usually means treatment needs to continue or change.

Remission does not mean “you are cured”. A small number of cells that the microscope cannot see may remain. More sensitive MRD tests look for them, and the next phases of treatment aim to destroy them.

When remission lasts a long time, for years, and the leukemia does not return, doctors may begin to talk about cure. How long this takes depends on the type of leukemia, so ask your own doctor this question.

03Scientific explanation

In acute myeloid leukemia (AML): according to the 2022 ELN recommendations, complete remission requires fewer than 5% blasts in the bone marrow, no blasts in the blood, no disease outside the marrow, neutrophils of at least 1.0×10⁹/L and platelets of at least 100×10⁹/L. If counts have only partly recovered, the report may say “complete remission with partial hematologic recovery” (CRh) or “with incomplete recovery” (CRi). A negative MRD result is also recorded separately.

In acute lymphoblastic leukemia (ALL): according to the NCI and the American Cancer Society, remission is defined by similar criteria, with fewer than 5% blasts in the marrow and recovered blood counts. In ALL, the MRD level at the end of induction is one of the most important prognostic factors and helps decide how intensive further treatment should be.

In chronic myeloid leukemia (CML): according to the 2020 ELN recommendations, response is measured in steps: complete hematologic response (normal blood counts), complete cytogenetic response (the Philadelphia chromosome can no longer be seen) and molecular response (the BCR::ABL1 level measured by PCR). A major molecular response means BCR::ABL1 of 0.1% or less on the international scale; a deeper response allows some patients to discuss stopping treatment under close monitoring.

In chronic lymphocytic leukemia (CLL), and maintenance: the 2018 iwCLL criteria define complete and partial response by the state of the lymph nodes, spleen, blood counts and bone marrow. In AML, maintenance with oral azacitidine in some patients in first remission improved overall survival in the 2020 QUAZAR trial; the hematologist decides who it suits.

04What happens in the body?

How is remission confirmed?

After a set phase of treatment, for example at the end of induction in acute leukemias, a blood test and usually a bone marrow test are done. Blasts are counted under the microscope, and flow cytometry and molecular tests look more deeply. Results can take several days; the wait is hard, but it is completely normal.

The depth of remission

Remission can be pictured in layers: first the blood counts return to normal, then the microscope can no longer see leukemia cells, and then even sensitive tests find no traces. The deeper the layer at which a “clear” result is obtained, the lower, on average, the chance of the leukemia coming back. But each result is only one part of the whole picture.

Several translucent glowing layers stacked one below another on a dark navy background; only a few faint points of light remain in the deepest layers. — **Figure 2.**The depth of remission is measured in layers.

Why does treatment continue after remission?

During remission, millions of hidden cells may still be left in the body. Consolidation chemotherapy, maintenance treatment lasting years in ALL, targeted medicines or a stem cell transplant are there precisely to destroy these cells. Even if you feel well, do not stop planned treatment early.

A calm glowing path stretching towards a bright horizon on a dark navy background, with soft points of light evenly spaced along it. — **Figure 3.**After remission, the road continues with follow-up and protective treatment.

Remission in chronic leukemias

In CML, treatment is often long-term medication, and the goal is to reach a deep molecular response and keep it. In CLL, the disease is sometimes watched for years without treatment. In these leukemias the word “remission” carries a slightly different meaning than in acute leukemias.

Looking after yourself in remission

Remission brings relief, but tiredness, anxiety and the question “what now?” are normal too. Go to follow-up visits on time and tell your team about new signs such as fever, bruising, lasting tiredness or bone pain. Sharing your feelings with loved ones or a psychologist makes this transition easier.

05From diagnosis to remission and beyond

The main stages of the road in acute leukemia (simplified).

1DiagnosisThe marrow is packed with leukemia cells.

2InductionMost leukemia cells are destroyed.

3RemissionThe marrow makes healthy cells again.

4After remissionConsolidation, maintenance or a transplant.

MRD testsShow how deep the remission is.

Follow-upRegular check-ups and tests.

Lasting remissionOver time, strengthens the hope of cure.

06Types of remission and response (simplified)

Term	What it means	Where it is used
Complete remission (CR)	Fewer than 5% blasts in the marrow, blood counts recovered	AML, ALL
CRh / CRi	Complete remission, but blood counts only partly recovered	AML, ALL
MRD-negative remission	Even sensitive tests find no trace of leukemia	AML, ALL, CLL
Partial remission / response	Leukemia much reduced but not gone	All types
Major molecular response	BCR::ABL1 of 0.1% or less	CML
Deep molecular response	BCR::ABL1 even lower or barely detectable	CML

* Criteria vary with the type of leukemia and the guidelines used. Your hematology team will explain what your results mean.

07Key terms

Remission: A decrease in or disappearance of the signs of leukemia after treatment.
Complete remission: No trace of leukemia on standard tests, with recovered blood counts.
Partial remission: Leukemia reduced but not completely gone.
Blast: An immature cell; their number rises in acute leukemia.
Induction: The first intensive treatment, aimed at reaching remission.
Consolidation: Treatment after remission to destroy hidden cells.
Maintenance: Long-term, usually gentler treatment to keep remission.
MRD: Measurable residual disease: a small number of leukemia cells found by sensitive tests.
Molecular response: In CML, a fall in the BCR::ABL1 level.
Relapse: The return of leukemia after remission.

08Key points

Remission is a big step that shows treatment is working.
In complete remission, marrow blasts are below 5% and blood counts recover.
Remission does not yet mean cure.
Treatment continues after remission to destroy hidden cells.
MRD tests show how deep the remission is.
In chronic leukemias, response is measured in steps.
Do not skip follow-up visits.
Discuss your results with your hematology team.

09Frequently asked questions

Does remission mean cure?

Not yet. Remission means the leukemia cannot be found right now. When remission lasts for years, doctors may talk about cure. According to the American Cancer Society, for example, it is unusual for ALL to come back if there are still no signs of it 5 years after treatment.

How long does it take to reach remission?

In acute leukemias, the first assessment is usually done at the end of induction, about a month later. Sometimes a second induction course is needed. In chronic leukemias, the response deepens gradually over months.

I am in remission, so why do I need another bone marrow test?

Some important information, especially the MRD level, can only be obtained from the marrow. These results help choose the next treatment. Your doctor decides how often tests are needed.

Why do I still feel tired in remission?

After intensive treatment, the body can take months to recover. If tiredness is severe or getting worse, tell your team: causes such as anemia, thyroid problems or depression can be checked.

What if my remission is “partial”?

It means the leukemia is responding to treatment but has not gone completely. Doctors may suggest continuing or changing treatment, or other options. It does not mean that hope is lost.

What should I watch for in remission?

Tell your team about fever, unexplained bruising or bleeding, lasting tiredness, bone pain or swollen lymph nodes. Most of the time the cause is not serious, but it is important to be checked in good time.

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.

Am I in remission, and how was that confirmed?
What is my MRD result, which shows how deep the remission is?
Do I need to continue treatment even though I am in remission?
When will the next check-ups be?

My questions

12Sources

National Cancer Institute (NCI). NCI Dictionary of Cancer Terms: remission
National Cancer Institute (NCI). NCI Dictionary of Cancer Terms: complete remission
National Cancer Institute (NCI). Adult Acute Myeloid Leukemia Treatment (PDQ®) – Patient Version
National Cancer Institute (NCI). Adult Acute Lymphoblastic Leukemia Treatment (PDQ®) – Patient Version
National Cancer Institute (NCI). Chronic Myeloid Leukemia Treatment (PDQ®) – Patient Version
National Cancer Institute (NCI). Chronic Lymphocytic Leukemia Treatment (PDQ®) – Patient Version
American Cancer Society. Acute Myeloid Leukemia (AML) Subtypes and Prognostic Factors
American Cancer Society. Acute Lymphocytic Leukemia (ALL) Subtypes and Prognostic Factors
American Cancer Society. Living as an Acute Myeloid Leukemia Survivor
American Cancer Society. Living as an Acute Lymphocytic Leukemia Survivor
Blood, 2022. Diagnosis and management of AML in adults: 2022 recommendations from an international expert panel on behalf of the ELN
Leukemia, 2020. European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia
Blood, 2018. iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL
New England Journal of Medicine, 2020. Oral Azacitidine Maintenance Therapy for Acute Myeloid Leukemia in First Remission

Medical disclaimerThis information is for educational purposes only and does not replace medical advice.

Last updated: 3 October 2026← Back to the list

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