After ALL treatment

What follow-up do I need?

Once treatment is over and you are in remission, you will still need to go back to hospital for regular check-ups. This is called follow-up.

Tell your doctor if there are any changes in your body or any new symptoms. You will probably have more bone marrow tests to make sure you are still in remission.

At first, your follow-up visits will be quite often but will become less frequent the longer you are well and free from disease. During the first year you may be checked every 1–2 months. After 5 years you will have yearly check-ups.

Sometimes you may need to go to hospital if you get an infection, as your immune system takes time to recover.

If you have had an allogeneic stem cell transplant, you will have regular follow-up appointments on a long-term basis. This means you will have the chance to talk to your medical team and get help with any late effects of the treatment.

If you are between check-ups and have a symptom or problem that is worrying you, call your specialist nurse for advice or to arrange an earlier outpatient appointment if necessary.

If you become suddenly unwell and can’t contact your specialist nurse or hospital team, go to your GP or the accident and emergency department at the hospital.

What if the ALL comes back?

If the leukaemia cells come back after being treated it’s called a relapse or recurrence. A relapse can happen during or soon after treatment, or months or years later.

Your doctor can decide if you have a low, moderate or high risk of relapsing. This is based on your white cell count at diagnosis, any cytogenetic or genetic changes in your ALL cells, your age and your response to your first treatment.

You can relapse:

While on treatment: The reason you relapse while on treatment may be because the disease has become resistant to the drugs being used. This is known as refractory disease. In this case, other drugs that work well in leukaemia will be given to you. A stem cell transplant might also be considered as a treatment for some patients.

After treatment: If you relapse some time after treatment, you might have the same chemotherapy drugs you were first treated with, as you responded well to them. New treatment options will also be discussed with you. More treatment may or may not include a stem cell transplant.

Feelings after treatment

It can take some time to come to terms with a cancer diagnosis, even after your treatment has ended. Read about feelings after treatment and where to get support.

Living a healthy lifestyle

Many people want to live a healthy lifestyle after a cancer diagnosis. Get some advice on healthy living here.

Take care of your health

Allow your body the time it needs to recover.
Take precautions to avoid infections. Contact your doctor straight away if you have signs of infection or symptoms of ALL.
Have regular dental and eye check-ups.
Your skin will remain sensitive to the sun following chemotherapy and there can be an increased risk of developing skin cancer following treatment for ALL. Wear protective clothing such as long sleeves and hats in the sun and always remember to wear sunscreen.