Leukemia (Blood Cancer)

Bharat R Agarwal
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Relapse- All
Relapse may occur during or after completion of therapy and may occur in the bone marrow, testes or CNS. Allogenic bone marrow transplant should be considered in early relapse in therapy or within 6 months of termination of therapy or late marrow relapse with high tumor load as indicated by a peripheral blast count of 10,000/ul or more. For patients with late relapse (> 36 months in remission), a primary chemotherapy approach should be considered with bone marrow transplantation reserved for a subsequent marrow relapse.

Various statistical studies show that median duration of complete remission is 12 - 18 months with some form of intensive post - remission therapy. There is 25 - 50% chance of 3 - 5 year disease free interval in selected studies. Relapses are rare after 4 - 5 years. However, prognosis for a child with recurrent or progressive AML is poor. The long term survival rates after BMT is 45 - 50% (first remission), 25 - 30% (second remission), 15 - 20% (in relapse). However, the mortality rate after BMT is approximately 25 - 50%. The major causes of morbidity and mortality are infection and bleeding due to pancytopenia.


Leukemia (Blood Cancer) Leukemia (Blood Cancer) 2/2/2001
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