CHILDHOOD ACUTE LYMPHOBLASTIC-LEUKEMIA - ARE ROUTINE END-OF-THERAPY BONE-MARROW AND CEREBROSPINAL-FLUID EXAMINATIONS NECESSARY

Objective: To ascertain the usefulness of bone marrow and cerebrospina l fluid (CSF) examinations in identifying or predicting relapse in chi ldren with acute lymphoblastic leukemia (ALL) before discontinuation o f chemotherapy. Material and 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 aspirat ion and CSF examinations. Results: One patient had frank bone marrow r elapse 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. Conclusi on: Routine morphologic examination of the bone marrow and CSF at the completion of therapy for ALL has no diagnostic or prognostic value.