Prognostic impact of need for re-induction based on day-14 residual disease and age-adapted consolidation strategy in acute myeloid leukemia

The primary goal of induction therapy in acute myeloid leukemia (AML) is to induce complete remission with hematologic recovery (CR) or incomplete hematologic recovery (CRi) [ 1 ]. In patients receiving intensive chemotherapy, guidelines suggest considering bone marrow evaluation at day 14 and re-induction if residual disease ( > 5% blasts) is present [ 2 ]. However, despite prior studies reporting a prognostic role of residual disease at D-14, its utility has not been widely accepted as an independent prognostic factor, and other studies have reported no consistent association with long-term outcomes [ 3 , 4 , 5 , 6 ]. Additionally, depending on underlying genetic risk and performance status, patients achieving CR/CRi may proceed with either allogeneic stem cell transplant (ASCT) or multiple cycles of consolidation chemotherapy, which may include anthracycline-based or cytarabine-only regimens [ 2 , 7 ].