A Quality Improvement Initiative: Routine End of Therapy Bone Marrow Aspirates in Pediatric B cell Acute Lymphoblastic Leukemia in Oman

The utility of end of treatment bone marrow aspirates (EOTBMA) and cerebral spinal fluid analysis (EOTCSF) in B-cell acute lymphoblastic leukemia (B-ALL) is unclear. A retrospective review, n=50, B-ALL age 1-18 years at diagnosis, having EOTBMA and EOTCSF, at a single institution 2010-2018 was conducted. No bone marrow or CNS relapse was detected by EOTBMA or EOTCSF. 4/50 (8.0%) patients relapsed at a median of 2.5 years (range 0.9-4.5 years). Consensus to abandon routine EOTBMA occurred by presenting results to faculty. Our data supports absence of utility of routine EOTBMAs and EOTCSF in pediatric B-ALL. Disseminating local data facilitated consensus in implementing best practice.