title: Childhood acute lymphoblastic leukemia: are routine end-of-therapy bone marrow and cerebrospinal fluid examinations necessary?
abstract: OBJECTIVE
  To ascertain the usefulness of bone marrow and cerebrospinal fluid (CSF) examinations in identifying or predicting relapse in children with acute lymphoblastic leukemia (ALL) before discontinuation of chemotherapy.
  
  
  METHODS
  We retrospectively reviewed the medical records of 113 children with ALL in first continuous complete remission who had undergone routine end-of-therapy bone marrow aspiration and CSF examinations.
  
  
  RESULTS
  One patient had frank bone marrow relapse at the completion of therapy, which was evident by the presence of blasts in the peripheral blood. None of the other 112 patients had morphologic evidence of bone marrow relapse or positive CSF cytologic findings. The seven subsequent relapses could not have been predicted by the results of end-of-therapy bone marrow or CSF studies.
  
  
  CONCLUSIONS
  Routine morphologic examination of the bone marrow and CSF at the completion of therapy for ALL has no diagnostic or prognostic value.
authors.affiliation: Section of Pediatric Hematology/Oncology, Mayo Clinic Rochester, Minnesota 55905, USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: Hutt
authors.forename: H
authors.initials: H
authors.lastname: Sabio
authors.forename: G S
authors.initials: GS
authors.lastname: Gilchrist
authors.forename: C
authors.initials: C
authors.lastname: O'Brien
mesh_terms: D000293:Adolescent; D001853:Bone Marrow / Q000473:pathology*; D002555:Cerebrospinal Fluid / Q000166:cytology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000134:cerebrospinal fluid* / Q000188:drug therapy / Q000473:pathology*; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies