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Follow-up after treatment for acute lymphocytic leukemia
Follow-up after treatment is an important part of cancer care. Follow-up for acute lymphocytic leukemia (ALL) is often shared among the cancer specialists (oncologists or hematologists) and your family doctor. Your healthcare team will work with you to decide on follow-up care to meet your needs.
Don’t wait until your next scheduled appointment to report any new symptoms and symptoms that don’t go away. Tell your healthcare team if you have:
- a general feeling of discomfort or illness (called malaise)
- loss of appetite
- weight loss
- bleeding or bruising
- frequent infections
The chance of ALL recurring is greatest within 5 years after finishing treatment, so close follow-up is needed during this time. If a relapse occurs, it is usually during treatment or shortly after treatment is completed. It is unusual for ALL to return if there are no signs of the disease 5 years after treatment.
Schedule for follow-up visits
Follow-up after ALL is based on your personal needs. It generally lasts for many years. Follow-up visits for ALL are usually scheduled:
- every few months for 5 years after treatment is finished (even if there are no signs of disease)
- more frequently, likely once or twice a week, for the first 3 months after a stem cell transplant
- less frequently as time goes on (the time between exams will become longer but they will continue indefinitely)
During follow-up visits
During a follow-up visit, your healthcare team will usually ask questions about the side effects of treatment and how you’re coping.
Your doctor may do a physical exam, which can include:
- measuring vital signs for fever, shortness of breath and rapid heartbeat
- checking the skin for bruising and paleness
- feeling areas of the neck, underarm and groin for any swollen, or enlarged, lymph nodes
- looking in the mouth for signs of infection and bleeding or swollen gums
- feeling the abdomen for enlarged organs
- checking the skeleton for tenderness or pain
Tests are often part of follow-up care. You may have:
- complete blood count (CBC) to check for abnormal blood cell counts
- blood chemistry tests to show how well certain organs are working and find problems caused by the spread of leukemia cells
- imaging tests, such as chest x-ray, CT scan, MRI or ultrasound, to get helpful information about the spleen, liver or lymph nodes
- bone marrow aspiration and biopsy to follow up after the results of the blood tests or if new symptoms develop
If a recurrence is found, your healthcare team will assess you to determine the best treatment options.
Find out more about these tests and procedures.
Questions to ask about follow-up
To make the decisions that are right for you, ask your healthcare team questions about follow-up.
Providing rides to cancer treatment
For more than 50 years, the Canadian Cancer Society’s transportation program has enabled patients to focus their energy on fighting cancer and not on worrying about how they will get to treatment.