Table 3. A suggested approach to... | American Society of Hematology

Table 3.

A suggested approach to management of relapsed ALL.

*Risk Group (%^)**	Type of Relapse	EFS	Possible Treatment
High (25%)	Early bone marrow or combined	5-15%	Intensify early chemotherapy New agents as available Sibling or unrelated donor transplant Modification of transplant approach
	Early CNS with adverse factors	20-25%
	? Early testis
Medium (65%)	Bone marrow relapse 2-4 yr.	40-60%	Sibling transplant Use minimal residual disease to stratify Randomize minimal residual disease-negative to transplant vs. chemotherapy
	Combined relapse	40-60%
Low (10%)	Very late bone marrow relapse	? 60-70%	Intensified chemotherapy Local irradiation as appropriate
	Late extramedullary relapse	60-80%

*Risk Group (%^)**	Type of Relapse	EFS	Possible Treatment
High (25%)	Early bone marrow or combined	5-15%	Intensify early chemotherapy New agents as available Sibling or unrelated donor transplant Modification of transplant approach
	Early CNS with adverse factors	20-25%
	? Early testis
Medium (65%)	Bone marrow relapse 2-4 yr.	40-60%	Sibling transplant Use minimal residual disease to stratify Randomize minimal residual disease-negative to transplant vs. chemotherapy
	Combined relapse	40-60%
Low (10%)	Very late bone marrow relapse	? 60-70%	Intensified chemotherapy Local irradiation as appropriate
	Late extramedullary relapse	60-80%

^*

Estimated proportion of all relapses