Low-Risk Chronic Leukaemia: No Specialised Follow-Up - EMJ

Specialised Follow-up May Be Unnecessary for Low-Risk Chronic Leukaemia

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LOCAL hospital management has implemented a groundbreaking strategy to optimise healthcare resources for patients with chronic lymphocytic leukaemia (CLL). A recent study highlighted the feasibility and safety of ending specialised follow-up (sFU) for asymptomatic patients with CLL deemed low-to-intermediate risk.

The study, conducted over 3 years, evaluated 112 patients selected for ending sFU compared to 88 patients continuing sFU. Remarkably, patients who ceased sFU experienced similar overall survival rates compared to those continuing sFU, with 87% and 80% survival rates, respectively, at the end of the observation period.

Notably, ending sFU led to fewer hospital visits per patient-year, a stark contrast to the higher frequency observed in patients continuing sFU. Additionally, patients who ceased sFU enjoyed an extended time to first infection, including fewer instances of COVID-19 infections, underlining the potential benefits of this strategy in the context of pandemic management.

The study also revealed a lower rate of first treatment initiation among patients ending sFU, highlighting the potential sparing of unnecessary medical interventions. Importantly, thorough clinical evaluations were conducted prior to discontinuing sFU, ensuring patient safety and adherence to established protocols.

The lead author of the study, Christian Brieghel, Rigshospitalet, Copenhagen, Denmark, expressed optimism about the implications of these findings, stating: “It is feasible and safe to end sFU for patients with CLL who have low to intermediate risk scores, provided thorough clinical evaluation is undertaken.”

This paradigm shift in CLL management not only optimises healthcare resources but also underscores the importance of tailored approaches in delivering patient-centred care. As healthcare systems evolve, initiatives like this pave the way for more efficient and effective allocation of resources, ultimately benefiting patients and healthcare providers alike.



Brieghel C et al. It is feasible and safe to stop specialized follow-up of asymptomatic lower risk chronic lymphocytic leukemia. Blood Adv. 2024;DOI:10.1182/bloodadvances.2023012382.

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