Are regular blood and bone marrow tests helpful after childhood leukaemia?

Follow-up of children after treatment for leukaemia aims to find out if their cancer has come back (relapsed), pick up any side effects of treatment, and to provide information and support for families.

Having many follow-up tests can cause problems, such as pain from blood tests, having anaesthetics for bone marrow tests, increasing anxiety for families, and higher costs for the NHS. Some small research studies have shown that most leukaemia relapses are found when the child develops symptoms, instead of being found through tests. They also suggest that finding out that a child has relapsed through tests might not improve their chances of survival. However, the studies were not big enough to tell us for sure whether the tests help or not.

Dr Jess Morgan and her team at the University of York will be asking two questions:

• What is current follow-up like in the UK?
  The researchers will ask all 21 UK hospitals that lead on the care of children with leukaemia what tests they currently do after treatment, then compare the differences between centres, including what tests are done and how often.
• Are regular tests checking for relapse after leukaemia treatment helpful?
  The team will look at all previous research about routine tests to get an accurate answer about whether they improve survival, their effect on patient experience, any harm from doing the tests, and costs to families and health services. They will look at whether different information, like the type of leukaemia or the treatments a child had, makes the tests more or less helpful.

A clinical advisory group made up of experts in leukaemia, including professionals and parents, will be helping find the best possible answers to these questions. The researchers will share these answers with families, researchers and health professionals, which Dr Jess Morgan hopes will help provide better follow-up for children with leukaemia.