Routine bone marrow punctures during remission of acute myelogenous leukemia

To determine whether serial examinations of the peripheral blood can replace regular bone marrow punctures in the diagnosis of a relapse of acute myelogenous leukemia (AML), the peripheral blood of 40 AML patients in remission undergoing regular bone marrow punctures was studied. Within three months prior to bone marrow examination proving relapse in 97% of the relapses, at least one of the following values of the peripheral blood was pathological: blasts (84%), neutrophil granulocytes (72%), thrombocytes (64%), and hemoglobin (58%). The simultaneous appearance of abnormalities in the peripheral blood and the bone marrow occurs in such high incidence that routine bone marrow punctures are rendered obsolete in the follow-up of AML patients. Needless pain and anxiety can therefore be avoided for many AML patients.