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Fig. 2 | BMC Systems Biology

Fig. 2

From: In-silico comparison of two induction regimens (7 + 3 vs 7 + 3 plus additional bone marrow evaluation) in acute myeloid leukemia treatment

Fig. 2

Exemplary simulations of a fast pace leukemia. The simulations started in the steady state of the healthy hematopoietic model. A small amount of leukemic cells (l1) with proliferation p = 2 and self-renewal a = 1 was introduced at Time = 0. The simulation shows the development of a leukemia that reaches the diagnostic threshold (20% blasts) at day 63. Treatment starts immediately (monotherapy with 7 days cytarabine). Healthy and leukemic compartments immediately react to the chemotherapy and get depleted. Panels a and b show the simulated trajectories within the standard arm. The neutropenic phase lasts ca. 20 days (Panel a). During this phase the relative blasts count (%, panel b) is high due to the very low absolute cell counts. This simulation shows the occurrence of a complete remission. The l1 cells (HSC) can be cleaned by therapy. The total blasts clearance (also for the l2 compartment) takes until day 90 to 100. Panels c and d (Evaluation arm) show, in contrast to the standard arm a prolonged neutropenic phase (plus additional 20 days). This is induced by the second course, which is applied during the already recovering normal hematopoiesis

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