In acute myeloid leukemia (AML) with first induction chemotherapy, if the bone marrow primitive cells are <5% after treatment, conventional wisdom and guidelines recommend observation without treatment, even in the presence of persistent low absolute neutrophil count (ANC) and/or low platelet count. These guidelines suggest that patients can achieve complete remission (CR) without further treatment, i.e., ANC ≥ 1000/μl, platelet count ≥ 100,000/μl, and bone marrow primitive cells < 5%. A recent study by Professor Chen, USA, to assess the correlation between ANC and platelet counts and possible late CR rates and survival without further treatment in patients with a bone marrow primitive cell count of <5% at day 21 of the first induction chemotherapy was published in the latest issue of Leukemia. A total of 343 patients with primary AML (excluding APL) and MDS with a primitive cell ratio of 15-19% were enrolled in the study, and 85 patients with a bone marrow primitive cell count <5% on days 21C28, 29C35, 36C42, or 43C49 after treatment were selected. If multiple bone punctures were performed on days 21-49, only the first bone puncture result was used as a reference. We performed a multifactorial analysis using Cox regression models to assess the independent effects of ANC and platelet count on the likely time to CR and patient survival in patients on course 1. Of all patients, 66% received standard 3+7 regimen chemotherapy, 21% received high-dose cytarabine, 7% received low-dose cytarabine chemotherapy, and 9% were treated with a cytarabine-free regimen. Sixty-four percent of these patients achieved CR in the first course, and the median survival was 13.1 months. Twenty-one days after the end of chemotherapy, the CR rate was 44% in patients with platelet counts <30,000/μl, 66% in patients between 30,000/μl and 100,000/μl, and 95% in patients >30,000/μl. ANC had a similar trend to platelet counts, but its correlation was less than that of platelet counts. Overall, high platelet counts implied higher CR rates across time. In a multifactorial analysis, excluding factors such as patient age, primary or secondary AML and cytogenetic abnormalities, the results still suggested an independent correlation between high platelet count and high CR rate. After 21 days of treatment, the median survival was 6.4 months for 36 patients with platelets <30,000/μl and 10.6 months for 49 patients with platelets ≥30,000/μl. Multifactorial analysis still suggested that high platelet count was independently associated with longer survival. Therefore, the study concluded that further treatment, rather than observation, is needed for AML patients with persistently low platelet counts with <5% post-treatment bone marrow primitive cells, but randomized trials are still needed to confirm the superiority of further treatment.