title: The utility of end-of-treatment bone marrow aspirates in pediatric acute lymphoblastic leukemia: a quality improvement project.
abstract: We reviewed the use, results and costs of end-of-treatment bone marrow aspirates (EOTBMAs) performed locally in patients diagnosed with ALL between 2000 and 2005. Of 193 patients, 188(97%) received EOTBMAs. Though 15/188(8.0%) patients experienced relapse at a median time of 1.1 years (range 0.1-4 years), no sign of relapse was detected on any EOTBMA. After communication of results to clinical staff, only 2/17 (12%) of patients with ALL finishing treatment in the subsequent 5 months received an EOTBMA (P < 0.0001). Our results confirm the futility of EOTBMAs in a large contemporary cohort. Disseminating local results may help ensure adherence to best practices.
authors.affiliation: Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada. sumit.gupta@sickkids.ca
authors.forename: Sumit
authors.initials: S
authors.lastname: Gupta
authors.forename: Hannah L
authors.initials: HL
authors.lastname: Crump
authors.forename: Sarah
authors.initials: S
authors.lastname: Alexander
mesh_terms: D001856:Bone Marrow Examination / Q000191:economics / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D020732:Cytogenetic Analysis / Q000191:economics; D005434:Flow Cytometry / Q000191:economics; D006801:Humans; D017404:In Situ Hybridization, Fluorescence / Q000191:economics; D018447:Medical Futility; D016133:Polymerase Chain Reaction / Q000191:economics; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000628:therapy; D012008:Recurrence