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There is limited published data on the mode of relapse presentation in acute myeloid leukaemia (AML) and the efficacy of routine outpatient monitoring in detecting relapse. In diffuse large B cell lymphoma, studies looking at postremission surveillance imaging found that the majority of relapses were detected at patient self-presentation;1 however, there is no similar data available for AML. Such information would be of relevance to all patients in occupations requiring medical checks for public safety reasons, such as pilots and public transport drivers, where the risk of acute incapacitation must be assessed prior to employment health clearance.
A retrospective analysis was conducted of 101 cases meeting criteria for relapsed AML that were treated in our centre from September 2007 to February 2014, focusing on the mode of presentation and the severity of symptoms at the time of relapse. Patient characteristics are shown in table 1. The median age was 51 years (range 18–76 years) and 24 patients had received a T-replete reduced intensity allogeneic haematopoietic stem cell transplant (HSCT) as consolidation therapy in first remission (CR1). Our current surveillance practice, based on international guidelines for patients with AML who have completed therapy involves a full blood count (FBC) every 1–3 months for the first 2 years, then every 3–6 months up to 5 years and annually thereafter.2 During this period, minimal residual …