Lack of benefit of early detection of relapse after completion of therapy for acute lymphoblastic leukemia

Pediatric Blood & Cancer
J E RubnitzChing-Hon Pui

Abstract

Although most pediatric oncologists obtain routine blood counts in patients who have completed treatment for acute lymphoblastic leukemia (ALL), the value of this practice is unproven. We therefore sought to determine if detection of relapse by blood counts before the onset of symptoms provided any clinical benefit. We performed a retrospective review of 72 patients with ALL who suffered isolated or combined hematologic relapses after the completion of therapy. We compared attainment of second remission and survival after relapse among patients who were asymptomatic and diagnosed by routine blood count, those who had symptoms suggestive of relapse and were diagnosed at the time of a scheduled follow-up, and those whose relapse was diagnosed because of the appearance of symptoms. Only 11% of patients who suffered a relapse were asymptomatic at the time of relapse and diagnosed solely by routine blood counts. There were no significant differences in the survival distributions for the three groups of patients. In this cohort of patients with relapsed ALL, we found no evidence that detection of relapse by routine blood counts before the onset of symptoms leads to a better outcome.

References

Aug 27, 1998·The New England Journal of Medicine·C H Pui, W E Evans
Aug 15, 2003·The New England Journal of Medicine·Ching-Hon PuiMelissa M Hudson
Sep 25, 2003·JAMA : the Journal of the American Medical Association·Melissa M HudsonUNKNOWN Childhood Cancer Survivor Study Investigators
Oct 16, 2003·JAMA : the Journal of the American Medical Association·Ching-Hon PuiWilliam E Evans
Nov 18, 2003·British Journal of Haematology·Judith M ChessellsIan M Hann

❮ Previous
Next ❯

Citations

Aug 3, 2011·Radiologic Clinics of North America·R Paul GuillermanBruce R Parker
Jan 13, 2009·Artificial Intelligence in Medicine·Juan M CorchadoJavier Bajo
Mar 16, 2005·Pediatric Blood & Cancer·Hany Ariffin, Huay-Ling Lim
Dec 15, 2005·British Journal of Haematology·Paul S Gaynon
Aug 23, 2005·Cancer Chemotherapy and Biological Response Modifiers·Peter H Wiernik
Apr 26, 2016·Pediatric Hematology and Oncology·Jitsuda Sitthi-Amorn, Anderson B Collier
Oct 8, 2014·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Maddalena PaganinGiuseppe Basso
Dec 1, 2017·Pediatric Hematology and Oncology·Van HuynhMaureen M O'Brien
May 28, 2021·British Journal of Haematology·Karen S JensenUNKNOWN Nordic Society of Paediatric Haematology and Oncology (NOPHO)

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood And Marrow Transplantation

The use of hematopoietic stem cell transplantation or blood and marrow transplantation (bmt) is on the increase worldwide. BMT is used to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Here is the latest research on bone and marrow transplantation.