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Proposed paradigm shift suggests Osmotic Bio-Comminution improves AML outcomes by educating the immune system.
Acute myeloid leukemia (AML) remains lethal. Standard chemotherapy—epitomized by the "3+7" regimen [1]—reduces tumor burden but causes marrow aplasia, mucosal damage, and tumor lysis syndrome. Even with remission, leukemic stem cells (LSCs) in bone marrow (BM) niches drive relapse [2]. Chemotherapy's fundamental flaw: it destroys the immune system before tumor antigens can be presented. Allogeneic transplantation introduces HLA matching delays, graft‑versus‑host disease (GVHD), and lifelong immunosuppression. Both approaches treat the immune system as something to be "reset" or "replaced," rather than "educated." I propose Osmotic Bio‑Comminution (OBC) —a paradigm shift from chemical cytotoxicity to physical disruption. OBC eliminates malignant cells within the BM while simultaneously converting this process into an opportunity for autologous immune training.
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Li Chung Lee (2026) studied this question.
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