Traumatic lumbar puncture in children with acute lymphoblastic leukemia and its effect on central nervous system leukemia / 白血病·淋巴瘤

ABSTRACT

Objective To investigate the effect of traumatic lumbar puncture (TLP) on central nervous system leukemia (CNSL) in children with acute lymphoblastic leukemia and the related factors of TLP. Methods A retrospective analysis was performed from the medical records of 106 children with ALL who were diagnosed and treated from January 2010 to December 2014. The factors affecting the occurrence of TLP and the effect of TLP on the prognosis of children with ALL were analyzed. Results A total of 106 patients were treated for ALL during the study period, of which 21 cases (19.8 %) experienced TLP, median platelet count in 85 patients (80.2%) without TLP and in 21 patients with TLP was (72.50 ± 69.53) × 109/L and (31.10 ± 19.82) × 109/L (t= 2.69, P= 0.008). A receiver operating characteristic curve was constructed for predicting the risk of TLP based on platelet count. Platelet count of 34 ×109/L at the time of TLP had a sensitivity of 76%and specificity of 66%in predicting TLP. According to cerebrospinal fluid type, 1 case (4.8%) of TLP type had CNSL, and 2 cases (2.9%) of CNS1 type had CNSL (P>0.05). The 3-year event-free survival (EFS) rate in TLP group and CNS1 group had no significant difference [(82.8 ± 4.8) % vs. (74.7 ± 9.9)%, P>0.05]. Conclusions In the diagnostic lumbar puncture, platelet count<34 × 109/L is significantly associated with risk of TLP. TLP type does not contribute to inferior EFS and increase the incidence of CNSL.