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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.
Cancer affects all Canadians
Nearly 1 in 2 Canadians is expected to be diagnosed with cancer in their lifetime.