Brief Communication Acta Haematol 2015;133:168–171 DOI: 10.1159/000363405

Received: April 3, 2013 Accepted after revision: May 6, 2014 Published online: October 8, 2014

Safety and Cost-Effectiveness of a Simplified Method for Lumbar Puncture in Patients with Hematologic Malignancies Juan Antonio Flores-Jimenez Cesar Homero Gutierrez-Aguirre Olga Graciela Cantu-Rodriguez Jose Carlos Jaime-Perez Oscar Gonzalez-Llano Monica Sanchez-Cardenas Ana Cecilia Sosa-Cortez David Gomez-Almaguer

Lumbar puncture (LP) is a diagnostic or therapeutic procedure frequently used in hematological disease. Successful treatment of certain hematological malignancies depends largely on systemic and intrathecal chemotherapy (IT), the latter administered via LP [1]. Various malignant pathologies such as acute leukemia and some lymphomas require periodic LP in the course of their medical treatment [2, 3]. The hematological disease that most often requires handling by IT is acute lymphoblastic leukemia [4], with a total number of IT that varies from 4 to 22, depending on the treatment protocol [5–7]. LP is used to administer one or several drugs into the central nervous system [8, 9]. Although LP is generally a safe procedure, associated complications exist, such as infectious, noninfectious or traumatic events [10]. Red blood cell (RBC) contamination of cerebrospinal fluid (CSF) in the LP occurs in 8–19% of cases [11]. The most frequent complication is post-LP headache which occurs in 36.5–60% of patients [12]; other less frequent complications are brain herniation, cardiorespiratory compromise, local or referred pain, hemorrhage, subarachnoid epidermoid cyst, and CSF leak [12]. Infectious adverse events can be cellulitis, abscesses (spinal or epidural) or even meningitis [13]. LPs are performed using resources that include sterile drapes, sterile gloves, gauze, masks, equipment for LP, © 2014 S. Karger AG, Basel 0001–5792/14/1332–0168$39.50/0 E-Mail [email protected] www.karger.com/aha

a manometer, and anesthetic patches, among others [12]. Sometimes the support of fluoroscopy or ultrasound is needed during the procedure [14, 15]. Even with the use of all these aseptic measures, serious infectious adverse events occur in

Safety and cost-effectiveness of a simplified method for lumbar puncture in patients with hematologic malignancies.

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