Routine blood investigations have limited utility in surveillance of ...

Methods:
We conducted a multi-centre retrospective analysis of all patients diagnosed with aggressive lymphoma treated with curative-intent chemotherapy who achieved CR for at least 3 months between 2000 and 2015. An abnormal blood test was defined as any new and unexplained abnormality for full blood examination, lactate dehydrogenase or erythrocyte sedimentation rate.
Results:
Three hundred and forty-six patients attended a total of 3084 outpatient visits; blood tests were performed at 90% of these appointments. Fifty-six (16%) patients relapsed. Routine laboratory testing detected relapse in only three patients (5% of relapses); in the remaining patients, relapse was suspected clinically (80%) or detected by imaging (15%). The sensitivity of all blood tests was 42% and the positive predictive value was 9%. No significant difference in survival was shown in patients who underwent a routine blood test within 3 months prior to relapse versus those who did not (p = 0.88).
Conclusions:
Routine blood tests demonstrate unacceptably poor performance characteristics, have no impact on survival and thus have limited value in the detection of relapse in routine surveillance.
Conflict of interest statement
The authors declare no competing interests.
Figures
Fig. 1
Survival curve in relapsed patients.…
Fig. 1
Survival curve in relapsed patients. This shows the post-relapse survival based on whether…
Fig. 1
Survival curve in relapsed patients. This shows the post-relapse
survival based on whether a blood test was performed in preclinical period
(3 months) for relapse