NCCN Guidelines for Patients
Acute Lymphoblastic Leukemia, Version 1.2017
Follow-up after treatment for ALL
Liver function tests will be done to check how well
your liver is working. Some ALL treatments can
damage the liver and cause abnormal liver function
test results. But, this is usually temporary and should
go away over time.
A lumbar puncture removes a sample of spinal fluid
for testing. (See page 22 for more details.) This test
may be used to check for a CNS relapse. A CNS
relapse is when leukemia cells come back after
treatment and are found in the spinal fluid.
An echocardiogram is an imaging test that shows
how well your heart is working. Doctors use this
test to check for signs of heart damage that may be
caused by ALL treatments.
A bone marrow aspiration may also be done at
certain times during the first year of follow-up. When
this test is done, your doctor may want to perform
other lab tests on the bone marrow sample. This may
include flow cytometry, cytogenetic testing, FISH,
and PCR. See Part 2 on page 13 to read more about
each type of test for ALL.
Follow-up tests are given less often during the
second and third years of follow-up. During the
second year of follow-up, tests are recommended
once every three months. And during the third year
of follow-up, tests are only recommended once every
six months or as needed.
If follow-up tests show ALL has come back, more
treatment is needed. For relapsed Ph-positive ALL,
see Guide 16. For relapsed Ph-negative ALL, see
Guide 17 on page 67.