During traditional acute myeloid leukemia (AML) induction remission treatment, clinicians often perform an early bone marrow assessment to determine chemotherapy sensitivity, estimate prognosis, and adjust treatment regimens. Recently, Professor Zuluaga and others from the Division of Hematology and Oncology at the University of Miami School of Medicine questioned the validity of this bone marrow assessment and conducted a retrospective study showing that a mid-course (day 14) bone marrow assessment of >5% primitive cells did not mean chemotherapy failure and that re-induction therapy did not benefit the patient, as published in the American Journal of The article was published in the American Journal of Hematology. The study included 113 newly diagnosed AML patients undergoing induction therapy with a combination of cytarabine and an anthracycline “7+3” regimen, and their bone marrow was evaluated at diagnosis, mid-course (day 14), and recovery (days 21-42). At day 14, patients were divided into best response group (OR, primitive cells ≤ 5%) and poor response group (SOR, primitive cells > 5%) based on the proportion of primitive cells in the bone marrow. Patients in the SOR group were divided into those who underwent secondary induction (DI) and those who did not (SI) according to their clinical condition and physicians’ wishes. The study compared the rates of complete remission in the OR and SOR groups and in the DI and SI groups during the recovery period. The results of the study showed that 99 (87.6%) of the 113 patients included in the study achieved complete remission during the recovery period. At day 14, 90 patients (79.6%) had ≤ 5% primitive cells in the bone marrow, of whom 87 (96.7%) achieved complete remission during the recovery period. An additional 23 patients (20.4%) had a proportion of primitive cells in the bone marrow > 5%, of whom 11 (47.8%) received secondary induction and 12 (52.2%) were observed only and did not receive secondary induction therapy. The results showed no significant difference in complete remission rates between the two groups, 58.3% versus 45.5%, respectively. This result suggests that the percentage of patients who achieved complete remission during the recovery period was indeed much higher in the SOR group than in the patients with a primitive cell percentage ≤ 5% on day 14 bone marrow assessment. Notably, nearly half of the patients in the SOR group still achieved complete remission during the recovery period. Therefore, the use of day 14 bone marrow assessment results to estimate prognosis is not very meaningful. Moreover, since secondary induction therapy did not increase the likelihood of complete remission, the results of this bone marrow assessment are not very meaningful for guiding treatment. However, the day 14 marrow assessment is not entirely meaningless, and Prof. Zuluaga noted that clinicians need to analyze this marrow assessment on an individual basis, taking into account other high-risk factors such as cytogenetic abnormalities and peripheral blood primitive cell clearance, to determine the patient’s prognosis and whether the patient will benefit from re-induction therapy. Finally, Prof. Zuluaga suggested that a larger prospective study is needed to further validate the relevance of mid-course bone marrow assessment in AML patients.