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Follow-up care after treatment of leukemia

The follow-up arrangements are only guidelines and apply as long as the patient is in remission. For treatment that is potentially curative, the response is monitored multiple times during and after chemotherapy.

For palliative chemotherapy as well as for untreated patients under observation, the follow-up arrangement must be individualized.

All follow-up visits should include a medical history and clinical examination.

Blood testing is carried out at all visits and should include hematological tests with differential counts of leukocytes, blood smear, SR, LDH, and possibly liver and kidney function tests (especially after nephrotoxic therapy) and bone marrow smear.

The follow-up can be transferred to a local hospital according to guidelines from the specialist division, but it is very important that doctors at the local hospital have the competence and interest for this patient group. It is important to detect recurrence early in patients who are suitable for an allogeneic stem cell transplantation. It is also very important to be aware of the long-term side effects after treatment in this relatively young patient group. 

Complications

Fatigue

This patient group may be troubled by fatigue long after treatment is over. It may take months or sometimes years before returning back to a normal energy level. Some leukemia patients are relatively young and are students when they receive the diagnosis. Some may have problems resuming their studies due to difficulties concentrating and memory problems. 

Fertility

Fertility challenges are an increasing problem with increasing age and depend on the amount/type of treatment. For those who have completed sperm banking, it may be necessary to use assisted fertilization. Some younger patients will be able to conceive normally, but this is very uncommon after a myeloablative stem cell transplantation.

Psychological and socioeconomic problems 

Some patients benefit from speaking to a social worker or psychiatric nurse. 

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