Off-therapy procedures are not beneficial in pediatric B-cell acute lymphoblastic leukemia.
Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. Although curable, approximately 20% of patients relapse. In an effort to detect relapse earlier, our institution performed surveillance bone marrow (BM) and cerebrospinal fluid (CSF) evaluations every 3 months from the end of therapy to 1 year off. This study retrospectively reviewed all patients with B-cell ALL (B-ALL) from September 2005 to September 2010 to determine the benefit and cost of these procedures. Forty-one patients completed therapy and had 190 BMs and 190 lumbar punctures (LPs) performed. Four of 41 patients (9.8%) experienced a relapse. Relapse was detected in only 1 patient by routine BM evaluation (0.5%). Zero LPs were positive. The professional fees for the procedures were $8,738/patient. Therefore, off-therapy BM and CSF evaluations are not effective at detecting relapse and are expensive. Our institution has abandoned off-therapy surveillance for ALL.
a Staff Physician, Hospitalist Medicine , St. Jude Children's Research Hospital , Memphis , Tennessee , USA.
Jitsuda
J
Sitthi-Amorn
b Department of Pediatric Hematology-Oncology , University of Mississippi Medical Center , Jackson , Mississippi , USA.
Anderson B
AB
Collier
D000293:Adolescent; D001856:Bone Marrow Examination; D002648:Child; D002675:Child, Preschool; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D008297:Male; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000134:cerebrospinal fluid / Q000628:therapy*; D012008:Recurrence
Acute lymphoblastic leukemia; end of therapy; off therapy; pediatric; procedures