Longterm Followup

Follow-up plans for patients on a clinical trial should adhere to the scheme described in the study. There is no consensus for the follow-up of patients not enrolled on clinical trials. A general recommendation

(Table 14.5) would be to follow the patients monthly during the first year, every 2 to 3 months during the second and third years, and then at least every 6 months during the next 3 years. At 6 years and thereafter, patients can be monitored annually with history and physical examination, complete blood count with differential, and careful attention for second malignancies, heart failure, sterility, avascular necrosis, and hypothyroidism—all potential sequelae of therapy. Assessment of minimal residual disease should preferably be associated with clinical trials.

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