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The clinical value of follow‐up examinations in childhood T‐cell acute lymphoblastic leukemia and T‐cell non‐Hodgkin's lymphoma
Author(s) -
Huang L.,
Lequin M.,
Pieters R.,
van den HeuvelEibrink M.M.
Publication year - 2007
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.20813
Subject(s) - medicine , asymptomatic , lymphoblastic lymphoma , lymphoma , gastroenterology , bone marrow , t cell lymphoma , t cell , immunology , immune system
Background The aim of this study was to evaluate the value of follow‐up investigations of T‐cell acute lymphoblastic leukemia (T‐ALL) and T‐cell non‐Hodgkin's lymphoma (T‐NHL), including cerebrospinal fluid (CSF) examination, bone marrow (BM) aspiration, peripheral blood (PB) count, serum lactate dehydrogenase (LDH) and chest X‐rays in patients with an initial mediastinal enlargement. Procedure We reviewed clinical records of all T‐ALL patients from 1987 to 2002 and all T‐NHL patients from 1977 to 2002, seen at a single institution. Results Of 48 T‐ALL patients, 15 suffered from a relapse, 6 (40%) were asymptomatic at the time of relapse. T‐ALL (13/30) with mediastinal enlargement at first diagnosis relapsed versus 2/16 of those without mediastinal enlargement. However, at relapse, only one patient had a mediastinal mass, which in addition was symptomatic. Of 39 T‐NHL patients, 6 patients relapsed. Forty percent of relapsed T‐ALL and 17% of relapsed T‐NHL were asymptomatic. The seven asymptomatic relapses were detected by CSF (n = 4), BM (n = 2) or blood count (n = 1) examinations. All T‐ALL and T‐NHL patients with a mediastinal relapse were symptomatic. Conclusions This study suggests that routine CSF examinations during treatment can detect relapses of T‐ALL and T‐NHL before onset of symptoms, which might be of clinical value. Relapses are rarely detected by BM or blood examinations and whether this translates in a clinical benefit is unlikely. Routine chest X‐rays are not useful. Pediatr Blood Cancer © 2006 Wiley‐Liss, Inc.