European Journal of Cancer (2014) 50, 1482–1489
Available at www.sciencedirect.com
ScienceDirect journal homepage: www.ejcancer.com
The risk of traumatic lumbar punctures in children with acute lymphoblastic leukaemia Furqan Shaikh a,⇑, Laura Voicu b, Soumitra Tole b, Teresa To c, Andrea S. Doria d, Lillian Sung a, Sarah Alexander a a
Division of Haematology/Oncology, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada c Child Health Evaluative Sciences, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada d Department of Diagnostic Imaging, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada b
Received 12 August 2013; received in revised form 21 January 2014; accepted 11 February 2014 Available online 19 March 2014
KEYWORDS Spinal puncture Leukaemia Lymphoid Precursor cell lymphoblastic leukaemia-lymphoma Child Paediatrics
Abstract Background: Traumatic lumbar punctures with blasts (TLP+) in children with acute lymphoblastic leukaemia (ALL) obscure central nervous system status and are associated with a poorer event-free survival (EFS). Methods: We conducted a retrospective cohort study of all lumbar punctures (LPs) for children with ALL diagnosed at our institution from 2005 to 2009. We utilised random-effects and fixed-effects repeated-measures logistic regression analyses to identify risk factors for TLPs. Fixed-effects models use each patient as his or her own control. We used survival analysis to describe outcomes after a TLP+. Results: 264 children underwent 5267 evaluable lumbar punctures (LPs), of which 944 (17.9%) were traumatic. In the multivariable random-effects model, variables significantly associated with TLPs were age
Available at www.sciencedirect.com
ScienceDirect journal homepage: www.ejcancer.com
The risk of traumatic lumbar punctures in children with acute lymphoblastic leukaemia Furqan Shaikh a,⇑, Laura Voicu b, Soumitra Tole b, Teresa To c, Andrea S. Doria d, Lillian Sung a, Sarah Alexander a a
Division of Haematology/Oncology, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada c Child Health Evaluative Sciences, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada d Department of Diagnostic Imaging, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada b
Received 12 August 2013; received in revised form 21 January 2014; accepted 11 February 2014 Available online 19 March 2014
KEYWORDS Spinal puncture Leukaemia Lymphoid Precursor cell lymphoblastic leukaemia-lymphoma Child Paediatrics
Abstract Background: Traumatic lumbar punctures with blasts (TLP+) in children with acute lymphoblastic leukaemia (ALL) obscure central nervous system status and are associated with a poorer event-free survival (EFS). Methods: We conducted a retrospective cohort study of all lumbar punctures (LPs) for children with ALL diagnosed at our institution from 2005 to 2009. We utilised random-effects and fixed-effects repeated-measures logistic regression analyses to identify risk factors for TLPs. Fixed-effects models use each patient as his or her own control. We used survival analysis to describe outcomes after a TLP+. Results: 264 children underwent 5267 evaluable lumbar punctures (LPs), of which 944 (17.9%) were traumatic. In the multivariable random-effects model, variables significantly associated with TLPs were age
