Open-wedge testicular biopsy in childhood acute lymphoblastic leukemia after two years of maintenance therapy: Diagnostic accuracy and influence on outcome - A report from Children's Cancer Study Group

J. Nachman, N. F. Palmer, H. N. Sather, W. A. Bleyer, P. F. Coccia, J. N. Lukens, S. E. Siegel, G. D. Hammond

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28 Scopus citations


Bilateral testicular biopsies were performed on 708 males with acute lymphoblastic leukemia completing 24 to 30 months of maintenance chemotherapy in continuous remission. The 73 patients (10.3%) with occult testicular leukemia (TL) had a significantly increased risk of subsequent relapse (P = .0001) and death (P < .0001) when compared with patients with negative biopsies. Protocol-specified therapy for occult TL included reinduction therapy with concurrent bilateral testicular radiation, and 2 years of maintenance therapy. Four-year event-free survival for patients with negative biopsies was 78.2% ± 4% versus 65% ± 14% for patients with occult TL who received protocol-specified therapy (P = .05). This study suggests that (1) occult TL occurs in 10% of males completing 2 years of maintenance therapy; (2) occult TL significantly increases risk for subsequent relapse and death; (3) treatment results for occult TL and isolated overt off therapy TL (no previous biopsy) are similar; and (4) given current therapy, documentation of occult TL after 2 years of therapy does not improve disease-free survival.

Original languageEnglish (US)
Pages (from-to)1051-1055
Number of pages5
Issue number5
Publication statusPublished - Jan 1 1990


ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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