TY - JOUR
T1 - Prospective evaluation of clinical and laboratory effects of intrathecal chemotherapy on children with acute leukemia
AU - Keidan, Ilan
AU - Bielorei, Bela
AU - Berkenstadt, Haim
AU - Aizenkraft, Arik
AU - Harel, Ran
AU - Huna-Baron, Ruth
AU - Kaplinsky, Chaim
PY - 2005/6
Y1 - 2005/6
N2 - The objective of this prospective 18-month study was to evaluate the clinical and laboratory effects of repeated intrathecal injections of chemotherapy in children with acute leukemia. All procedures were performed under general anesthesia, and complications were prospectively recorded. Laboratory measurements included lumbar puncture opening pressure, cerebrospinal fluid (CSF) chemistry, and cell count and morphology. Central venous pressure and ophthalmologic examinations were also performed. Forty-seven children underwent 247 intrathecal injections of chemotherapy. Adverse effects (13.7% of the procedures) included nausea and vomiting, back pain, and headache. One child each had transient cauda equina syndrome, transient communicating hydrocephalus, and persistent sacral plexus injury. The mean lumbar puncture opening pressure was significantly higher after intrathecal therapy than before (22 ± 8 vs. 15 ± 9 cm H2O, P = 0.02) and higher than reported in age-matched children without leukemia. All CSF chemistries, cell count, and morphology were normal. The overall incidence of complications was 13.7%. Most were mild and resolved quickly, but significant neurologic complications did occur. Lumbar puncture opening pressure was significantly higher in children with acute leukemia after intrathecal chemotherapy.
AB - The objective of this prospective 18-month study was to evaluate the clinical and laboratory effects of repeated intrathecal injections of chemotherapy in children with acute leukemia. All procedures were performed under general anesthesia, and complications were prospectively recorded. Laboratory measurements included lumbar puncture opening pressure, cerebrospinal fluid (CSF) chemistry, and cell count and morphology. Central venous pressure and ophthalmologic examinations were also performed. Forty-seven children underwent 247 intrathecal injections of chemotherapy. Adverse effects (13.7% of the procedures) included nausea and vomiting, back pain, and headache. One child each had transient cauda equina syndrome, transient communicating hydrocephalus, and persistent sacral plexus injury. The mean lumbar puncture opening pressure was significantly higher after intrathecal therapy than before (22 ± 8 vs. 15 ± 9 cm H2O, P = 0.02) and higher than reported in age-matched children without leukemia. All CSF chemistries, cell count, and morphology were normal. The overall incidence of complications was 13.7%. Most were mild and resolved quickly, but significant neurologic complications did occur. Lumbar puncture opening pressure was significantly higher in children with acute leukemia after intrathecal chemotherapy.
KW - Acute leukemia
KW - Complications
KW - Increased intracranial pressure
KW - Intrathecal chemotherapy
KW - Lumbar puncture
KW - Neurotoxicity
KW - Post-dural puncture headache
UR - http://www.scopus.com/inward/record.url?scp=21244474412&partnerID=8YFLogxK
U2 - 10.1097/01.mph.0000168729.32463.7b
DO - 10.1097/01.mph.0000168729.32463.7b
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AN - SCOPUS:21244474412
SN - 1077-4114
VL - 27
SP - 307
EP - 310
JO - Journal of Pediatric Hematology/Oncology
JF - Journal of Pediatric Hematology/Oncology
IS - 6
ER -