Traumatic lumbar puncture at diagnosis adversely affects outcome in childhood acute lymphoblastic leukemia
The effect of traumatic lumbar puncture at the time of initial diagnostic workup on treatment outcome in children with newly diagnosed acute lymphoblastic leukemia (ALL) was investigated. The findings of the first 2 lumbar punctures performed on 546 patients with newly diagnosed ALL treated on 2 con...
Gespeichert in:
| Veröffentlicht in: | Blood 2000-11, Vol.96 (10), p.3381-3384 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 3384 |
|---|---|
| container_issue | 10 |
| container_start_page | 3381 |
| container_title | Blood |
| container_volume | 96 |
| creator | Gajjar, Amar Harrison, Patricia L. Sandlund, John T. Rivera, Gaston K. Ribeiro, Raul C. Rubnitz, Jeffrey E. Razzouk, Bassem Relling, Mary V. Evans, William E. Boyett, James M. Pui, Ching-Hon |
| description | The effect of traumatic lumbar puncture at the time of initial diagnostic workup on treatment outcome in children with newly diagnosed acute lymphoblastic leukemia (ALL) was investigated. The findings of the first 2 lumbar punctures performed on 546 patients with newly diagnosed ALL treated on 2 consecutive front-line studies (1984-1991) at St Jude Children's Research Hospital were retrospectively reviewed. Lumbar punctures were performed at the time of diagnosis and again for the instillation of first intrathecal chemotherapy. The event-free survival (EFS) experience for patients with 1 cerebrospinal fluid (CSF) sample contaminated with blast cells was worse than that for patients with no contaminated CSF samples (P = .026); that of patients with 2 consecutive contaminated CSF samples was particularly poor (5-year EFS = 46 ± 9%). In a Cox multiple regression analysis, the strongest prognostic indicator was 2 consecutive contaminated CSF samples, with a hazard ratio of 2.39 (95% confidence interval, 1.36-4.20). These data indicate that contamination of CSF with circulating leukemic blast cells during diagnostic lumbar puncture can adversely affect the treatment outcome of children with ALL and is an indication to intensify intrathecal therapy. |
| doi_str_mv | 10.1182/blood.V96.10.3381 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_72400016</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0006497120482746</els_id><sourcerecordid>72400016</sourcerecordid><originalsourceid>FETCH-LOGICAL-c491t-a170b384348987891f5a2596adad2d4c6b4e1d970b96837fd63d199bb6204a4f3</originalsourceid><addsrcrecordid>eNp9kE1r3DAQhkVpaLab_oBeiqDQmzcaW2tL9FRC-gGBXtJczVgad5XK1layAvvvq80u7a2ngeF5X2Yext6C2ACo-nrwIdjNg243ZdM0Cl6wFWxrVQlRi5dsJYRoK6k7uGSvU3oUAmRTb1-xSwDRQdvAij3eR8wTLs5wn6cBI9_n2Sw5EseFW4c_55Bc4mifKCbyB47jSGZJPOTFhIm4m7nZOW935RaOJi_E_WHa78LgMT33Uv5Fk8MrdjGiT_TmPNfsx-fb-5uv1d33L99uPt1VRmpYKoRODI2SjVRadUrDuMV6q1u0aGsrTTtIAqsLpFvVdKNtGwtaD0NbC4lybNbsw6l3H8PvTGnpJ5cMeY8zhZz6rpZFTHl_zeAEmhhSijT2--gmjIceRH8U3D8L7ovg4-YouGTencvzMJH9lzgbLcD7M4DJoB8jzsalv5zqQMquUB9PFBURT45in4yj2ZB1sdjtbXD_OeIPl0yaYg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>72400016</pqid></control><display><type>article</type><title>Traumatic lumbar puncture at diagnosis adversely affects outcome in childhood acute lymphoblastic leukemia</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><source>EZB Electronic Journals Library</source><creator>Gajjar, Amar ; Harrison, Patricia L. ; Sandlund, John T. ; Rivera, Gaston K. ; Ribeiro, Raul C. ; Rubnitz, Jeffrey E. ; Razzouk, Bassem ; Relling, Mary V. ; Evans, William E. ; Boyett, James M. ; Pui, Ching-Hon</creator><creatorcontrib>Gajjar, Amar ; Harrison, Patricia L. ; Sandlund, John T. ; Rivera, Gaston K. ; Ribeiro, Raul C. ; Rubnitz, Jeffrey E. ; Razzouk, Bassem ; Relling, Mary V. ; Evans, William E. ; Boyett, James M. ; Pui, Ching-Hon</creatorcontrib><description>The effect of traumatic lumbar puncture at the time of initial diagnostic workup on treatment outcome in children with newly diagnosed acute lymphoblastic leukemia (ALL) was investigated. The findings of the first 2 lumbar punctures performed on 546 patients with newly diagnosed ALL treated on 2 consecutive front-line studies (1984-1991) at St Jude Children's Research Hospital were retrospectively reviewed. Lumbar punctures were performed at the time of diagnosis and again for the instillation of first intrathecal chemotherapy. The event-free survival (EFS) experience for patients with 1 cerebrospinal fluid (CSF) sample contaminated with blast cells was worse than that for patients with no contaminated CSF samples (P = .026); that of patients with 2 consecutive contaminated CSF samples was particularly poor (5-year EFS = 46 ± 9%). In a Cox multiple regression analysis, the strongest prognostic indicator was 2 consecutive contaminated CSF samples, with a hazard ratio of 2.39 (95% confidence interval, 1.36-4.20). These data indicate that contamination of CSF with circulating leukemic blast cells during diagnostic lumbar puncture can adversely affect the treatment outcome of children with ALL and is an indication to intensify intrathecal therapy.</description><identifier>ISSN: 0006-4971</identifier><identifier>EISSN: 1528-0020</identifier><identifier>DOI: 10.1182/blood.V96.10.3381</identifier><identifier>PMID: 11071631</identifier><language>eng</language><publisher>Washington, DC: Elsevier Inc</publisher><subject>Adolescent ; Biological and medical sciences ; Central Nervous System Neoplasms - cerebrospinal fluid ; Central Nervous System Neoplasms - etiology ; Central Nervous System Neoplasms - pathology ; Child ; Child, Preschool ; Cohort Studies ; Disease-Free Survival ; Hematologic and hematopoietic diseases ; Humans ; Infant ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Medical sciences ; Neoplastic Cells, Circulating - pathology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - cerebrospinal fluid ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis ; Prognosis ; Retrospective Studies ; Spinal Puncture - adverse effects ; Spinal Puncture - standards ; Treatment Outcome</subject><ispartof>Blood, 2000-11, Vol.96 (10), p.3381-3384</ispartof><rights>2000 American Society of Hematology</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c491t-a170b384348987891f5a2596adad2d4c6b4e1d970b96837fd63d199bb6204a4f3</citedby><cites>FETCH-LOGICAL-c491t-a170b384348987891f5a2596adad2d4c6b4e1d970b96837fd63d199bb6204a4f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=871447$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11071631$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gajjar, Amar</creatorcontrib><creatorcontrib>Harrison, Patricia L.</creatorcontrib><creatorcontrib>Sandlund, John T.</creatorcontrib><creatorcontrib>Rivera, Gaston K.</creatorcontrib><creatorcontrib>Ribeiro, Raul C.</creatorcontrib><creatorcontrib>Rubnitz, Jeffrey E.</creatorcontrib><creatorcontrib>Razzouk, Bassem</creatorcontrib><creatorcontrib>Relling, Mary V.</creatorcontrib><creatorcontrib>Evans, William E.</creatorcontrib><creatorcontrib>Boyett, James M.</creatorcontrib><creatorcontrib>Pui, Ching-Hon</creatorcontrib><title>Traumatic lumbar puncture at diagnosis adversely affects outcome in childhood acute lymphoblastic leukemia</title><title>Blood</title><addtitle>Blood</addtitle><description>The effect of traumatic lumbar puncture at the time of initial diagnostic workup on treatment outcome in children with newly diagnosed acute lymphoblastic leukemia (ALL) was investigated. The findings of the first 2 lumbar punctures performed on 546 patients with newly diagnosed ALL treated on 2 consecutive front-line studies (1984-1991) at St Jude Children's Research Hospital were retrospectively reviewed. Lumbar punctures were performed at the time of diagnosis and again for the instillation of first intrathecal chemotherapy. The event-free survival (EFS) experience for patients with 1 cerebrospinal fluid (CSF) sample contaminated with blast cells was worse than that for patients with no contaminated CSF samples (P = .026); that of patients with 2 consecutive contaminated CSF samples was particularly poor (5-year EFS = 46 ± 9%). In a Cox multiple regression analysis, the strongest prognostic indicator was 2 consecutive contaminated CSF samples, with a hazard ratio of 2.39 (95% confidence interval, 1.36-4.20). These data indicate that contamination of CSF with circulating leukemic blast cells during diagnostic lumbar puncture can adversely affect the treatment outcome of children with ALL and is an indication to intensify intrathecal therapy.</description><subject>Adolescent</subject><subject>Biological and medical sciences</subject><subject>Central Nervous System Neoplasms - cerebrospinal fluid</subject><subject>Central Nervous System Neoplasms - etiology</subject><subject>Central Nervous System Neoplasms - pathology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cohort Studies</subject><subject>Disease-Free Survival</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Humans</subject><subject>Infant</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Medical sciences</subject><subject>Neoplastic Cells, Circulating - pathology</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - cerebrospinal fluid</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Spinal Puncture - adverse effects</subject><subject>Spinal Puncture - standards</subject><subject>Treatment Outcome</subject><issn>0006-4971</issn><issn>1528-0020</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1r3DAQhkVpaLab_oBeiqDQmzcaW2tL9FRC-gGBXtJczVgad5XK1layAvvvq80u7a2ngeF5X2Yext6C2ACo-nrwIdjNg243ZdM0Cl6wFWxrVQlRi5dsJYRoK6k7uGSvU3oUAmRTb1-xSwDRQdvAij3eR8wTLs5wn6cBI9_n2Sw5EseFW4c_55Bc4mifKCbyB47jSGZJPOTFhIm4m7nZOW935RaOJi_E_WHa78LgMT33Uv5Fk8MrdjGiT_TmPNfsx-fb-5uv1d33L99uPt1VRmpYKoRODI2SjVRadUrDuMV6q1u0aGsrTTtIAqsLpFvVdKNtGwtaD0NbC4lybNbsw6l3H8PvTGnpJ5cMeY8zhZz6rpZFTHl_zeAEmhhSijT2--gmjIceRH8U3D8L7ovg4-YouGTencvzMJH9lzgbLcD7M4DJoB8jzsalv5zqQMquUB9PFBURT45in4yj2ZB1sdjtbXD_OeIPl0yaYg</recordid><startdate>20001115</startdate><enddate>20001115</enddate><creator>Gajjar, Amar</creator><creator>Harrison, Patricia L.</creator><creator>Sandlund, John T.</creator><creator>Rivera, Gaston K.</creator><creator>Ribeiro, Raul C.</creator><creator>Rubnitz, Jeffrey E.</creator><creator>Razzouk, Bassem</creator><creator>Relling, Mary V.</creator><creator>Evans, William E.</creator><creator>Boyett, James M.</creator><creator>Pui, Ching-Hon</creator><general>Elsevier Inc</general><general>The Americain Society of Hematology</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20001115</creationdate><title>Traumatic lumbar puncture at diagnosis adversely affects outcome in childhood acute lymphoblastic leukemia</title><author>Gajjar, Amar ; Harrison, Patricia L. ; Sandlund, John T. ; Rivera, Gaston K. ; Ribeiro, Raul C. ; Rubnitz, Jeffrey E. ; Razzouk, Bassem ; Relling, Mary V. ; Evans, William E. ; Boyett, James M. ; Pui, Ching-Hon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c491t-a170b384348987891f5a2596adad2d4c6b4e1d970b96837fd63d199bb6204a4f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adolescent</topic><topic>Biological and medical sciences</topic><topic>Central Nervous System Neoplasms - cerebrospinal fluid</topic><topic>Central Nervous System Neoplasms - etiology</topic><topic>Central Nervous System Neoplasms - pathology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cohort Studies</topic><topic>Disease-Free Survival</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Humans</topic><topic>Infant</topic><topic>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>Medical sciences</topic><topic>Neoplastic Cells, Circulating - pathology</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - cerebrospinal fluid</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Spinal Puncture - adverse effects</topic><topic>Spinal Puncture - standards</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gajjar, Amar</creatorcontrib><creatorcontrib>Harrison, Patricia L.</creatorcontrib><creatorcontrib>Sandlund, John T.</creatorcontrib><creatorcontrib>Rivera, Gaston K.</creatorcontrib><creatorcontrib>Ribeiro, Raul C.</creatorcontrib><creatorcontrib>Rubnitz, Jeffrey E.</creatorcontrib><creatorcontrib>Razzouk, Bassem</creatorcontrib><creatorcontrib>Relling, Mary V.</creatorcontrib><creatorcontrib>Evans, William E.</creatorcontrib><creatorcontrib>Boyett, James M.</creatorcontrib><creatorcontrib>Pui, Ching-Hon</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Blood</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gajjar, Amar</au><au>Harrison, Patricia L.</au><au>Sandlund, John T.</au><au>Rivera, Gaston K.</au><au>Ribeiro, Raul C.</au><au>Rubnitz, Jeffrey E.</au><au>Razzouk, Bassem</au><au>Relling, Mary V.</au><au>Evans, William E.</au><au>Boyett, James M.</au><au>Pui, Ching-Hon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Traumatic lumbar puncture at diagnosis adversely affects outcome in childhood acute lymphoblastic leukemia</atitle><jtitle>Blood</jtitle><addtitle>Blood</addtitle><date>2000-11-15</date><risdate>2000</risdate><volume>96</volume><issue>10</issue><spage>3381</spage><epage>3384</epage><pages>3381-3384</pages><issn>0006-4971</issn><eissn>1528-0020</eissn><abstract>The effect of traumatic lumbar puncture at the time of initial diagnostic workup on treatment outcome in children with newly diagnosed acute lymphoblastic leukemia (ALL) was investigated. The findings of the first 2 lumbar punctures performed on 546 patients with newly diagnosed ALL treated on 2 consecutive front-line studies (1984-1991) at St Jude Children's Research Hospital were retrospectively reviewed. Lumbar punctures were performed at the time of diagnosis and again for the instillation of first intrathecal chemotherapy. The event-free survival (EFS) experience for patients with 1 cerebrospinal fluid (CSF) sample contaminated with blast cells was worse than that for patients with no contaminated CSF samples (P = .026); that of patients with 2 consecutive contaminated CSF samples was particularly poor (5-year EFS = 46 ± 9%). In a Cox multiple regression analysis, the strongest prognostic indicator was 2 consecutive contaminated CSF samples, with a hazard ratio of 2.39 (95% confidence interval, 1.36-4.20). These data indicate that contamination of CSF with circulating leukemic blast cells during diagnostic lumbar puncture can adversely affect the treatment outcome of children with ALL and is an indication to intensify intrathecal therapy.</abstract><cop>Washington, DC</cop><pub>Elsevier Inc</pub><pmid>11071631</pmid><doi>10.1182/blood.V96.10.3381</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0006-4971 |
| ispartof | Blood, 2000-11, Vol.96 (10), p.3381-3384 |
| issn | 0006-4971 1528-0020 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_72400016 |
| source | MEDLINE; Alma/SFX Local Collection; EZB Electronic Journals Library |
| subjects | Adolescent Biological and medical sciences Central Nervous System Neoplasms - cerebrospinal fluid Central Nervous System Neoplasms - etiology Central Nervous System Neoplasms - pathology Child Child, Preschool Cohort Studies Disease-Free Survival Hematologic and hematopoietic diseases Humans Infant Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Medical sciences Neoplastic Cells, Circulating - pathology Precursor Cell Lymphoblastic Leukemia-Lymphoma - cerebrospinal fluid Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis Prognosis Retrospective Studies Spinal Puncture - adverse effects Spinal Puncture - standards Treatment Outcome |
| title | Traumatic lumbar puncture at diagnosis adversely affects outcome in childhood acute lymphoblastic leukemia |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-20T18%3A50%3A01IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Traumatic%20lumbar%20puncture%20at%20diagnosis%20adversely%20affects%20outcome%20in%20childhood%20acute%20lymphoblastic%20leukemia&rft.jtitle=Blood&rft.au=Gajjar,%20Amar&rft.date=2000-11-15&rft.volume=96&rft.issue=10&rft.spage=3381&rft.epage=3384&rft.pages=3381-3384&rft.issn=0006-4971&rft.eissn=1528-0020&rft_id=info:doi/10.1182/blood.V96.10.3381&rft_dat=%3Cproquest_cross%3E72400016%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=72400016&rft_id=info:pmid/11071631&rft_els_id=S0006497120482746&rfr_iscdi=true |