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NCCN Guidelines for Patients



Acute Lymphoblastic Leukemia, Version 1.2017


Treatment guide

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.

Next steps

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.