Involvement of the cerebrospinal fluid cells in children with acute lymphoblastic leukemia: prognostic implications

Scrideli, Carlos Alberto

doi:10.5581/1516-8484.20120101

Cited by 4 publications

(5 citation statements)

References 18 publications

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“…The present study showed a higher incidence of CNS-3 and TLP+ in patients with high WCC (more than 50 x 10 9 white blood cells/L), those with T-cell ALL phenotype, and a high NCI risk, which is comparable with the findings of Lee et al and Smith et al [16,17]. However, these findings were not statistically significant.…”

Section: Discussionsupporting

confidence: 88%

“…However, these findings were not statistically significant. The current study also showed a higher incidence of CNS-3 with T-cell ALL phenotype (2.6%) in cohort B as compared with the incidence in international studies, the reason being a high incidence of T-cell ALL in our population, and hence a high proportion of CNS-3 cases [ 18 - 20 ].…”

Section: Discussionsupporting

confidence: 62%

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Central Nervous System Involvement in Childhood Acute Lymphoblastic Leukemia: An Analysis of Day-One Versus Day-Eight Lumbar Punctures in Remission Induction Therapy

Arshad¹,

Jabbar²,

Mansoor³

et al. 2021

Cureus

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Introduction Traumatic lumbar puncture (TLP+) can lead to the iatrogenic infiltration of the central nervous system (CNS) by circulating leukemic blast cells in childhood acute lymphoblastic leukemia (ALL). The risk of TLP+ is increased by a number of factors at the time of presentation of the disease, such as a high white cell count (WCC), T-ALL phenotype, and unstable clinical condition of the patient. For this reason, the first lumbar puncture (LP) was deferred until Day Eight of prednisolone prophase during remission induction therapy in one set of patients. The objective was to compare the historical cohort of Day-One LP with Day-Eight LP with respect to the incidence of TLP+ and de novo CNS leukemia. Methods A retrospective comparative data analysis of 1,185 childhood ALL patients aged 1-16 years was conducted based on the electronic medical records of the pediatric hematology-oncology department of The Indus Hospital (TIH), Karachi, from January 2010 to August 2018. A total of 600 patients whose LP was done on Day One (January 2010-May 2015) were placed in cohort A, whereas 585 patients whose LP was performed on Day Eight (June 2015-August 2018) were placed in cohort B. After the examination of the cerebrospinal fluid (CSF), the status of CNS infiltration was classified as CNS-1, CNS-2, CNS-3, and TLP+. Results A total of 1,185 patients were included in the study, of whom 600 patients were in cohort A and 585 patients in cohort B. The incidence of TLP+ was found to be lower in cohort B (1.7%) as compared with the incidence in cohort A (4.3%) (p-value=0.009). However, there was an increase in the incidence of CNS-3 cases in cohort B (8%) as compared to cohort A (3%) (p-value: <0.001). When the CNS status of both the cohorts was compared with that of the internationally published data, a low incidence of TLP+ cases was noted in patients with LP on Day Eight. Conclusion The modified approach of performing the first LP on Day Eight significantly reduced the incidence of TLP+ cases. However, an unusual finding of a significant increase in the CNS-3 leukemia was noted. More prospective studies are needed to investigate this significant increase in CNS-3 cases.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 62%

Central Nervous System Involvement in Childhood Acute Lymphoblastic Leukemia: An Analysis of Day-One Versus Day-Eight Lumbar Punctures in Remission Induction Therapy

Arshad¹,

Jabbar²,

Mansoor³

et al. 2021

Cureus

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“…CNS infiltration occurred throughout the course of treatment in 14 out of 64 ALL patients (21.8%). This percentage is higher than that reported in literature, which does not exceed 10% in most published data [2,3]. Our cases were selected as a consecutive cohort with no predilection to cases who are more prone to develop CNS disease.…”

Section: Discussionmentioning

confidence: 76%

“…This is attributed to improved supportive care, treatment modalities and prediction of relapse risk [1]. Central nervous system (CNS) involvement in childhood ALL is defined as five or more leukocytes/mm 3 and blast cells in cerebrospinal fluid (CSF) or cranial nerve palsy [2]. CNS involvement is rarely detected at initial presentation, while CNS relapses occur frequently.…”

mentioning

confidence: 99%

Evaluation of Multiplexed Biomarkers in Assessment of CSF Infiltration in Pediatric Acute Lymphoblastic Leukemia

Mikhael

Gendi

Hassab

et al. 2019

Int. J. Hematol. Oncol.

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Acute lymphoblastic leukemia (ALL) is a very common pediatric malignancy with high survival rates. The course of treatment is modified according to the occurrence of central nervous system (CNS) disease. Aim: To relate serum and cerebrospinal fluid levels of five biomarkers (matrix metalloprotienase 9, CCL-2, sVCAM-1, IFN-γ and inducible protein 10) at diagnosis to the development of CNS infiltration. Methods: The present study was carried on 64 children with ALL and 20 controls. Multiplexed cytokines were measured by Luminex technology (Matrix metalloprotienase 9, CCL-2, sVCAM-1, IFN-γ and inducible protein 10). Results: Significantly higher sMMP-9 and lower sCCL2 were found in patients who developed CNS leukemia. Conclusion: Serum multiplexed parameters at diagnosis of childhood ALL may predict of development of CNS leukemia.

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“…Identifying blast cells and their percentage in the CSF is an important prognostic factor in pediatric ALL and determines the incidence of relapse and need for the change in treatment protocol. 20 Tertirov et al 21 determined the role of early CSF examination in detecting true cases of early tumor dissemination and is important for determining both treatment and prognosis. It is important to identify infectious causes of exudative CSF effusion for early diagnosis, improvement in prognosis and reduce spread of disease and complication.…”

Section: Discussionmentioning

confidence: 99%

Exfoliative cytology of different body fluids- an important aid to primary diagnosis

Tiwari¹,

Thakur²,

Chandrakar³

et al. 2021

IJPO

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Background: Cytological examination of exfoliated cells in various effusion fluids is very challenging and of paramount importance for early diagnosis and management of various pathological processes. It is of utmost significance in identifying malignant cells and hence throws light on the cause, staging and prognosis of cancer. Aims and Objectives: This study was carried out to know the different trends of various types of effusions for various pathological processes with an emphasis on malignant effusion in a tertiary care centre. Materials and Methods: Retrospective, analytical, observational study done over a period of one year from January 2019 to December 2019. A total of 418 cases including peritoneal and pleural and cerebrospinal fluid and urine were analyzed. Samples were centrifuged for five minutes at 2000 rpm and smears prepared from deposit were stained by Papanicolaou (PAP) and May-Grunwald-Giemsa (MGG) stains. Results: Out of 418, 221 were peritoneal effusions, 172 were pleural, 20 cerebrospinal fluids and 5 urine. Out of 221 cases of peritoneal effusions, 144 were non neoplastic and 61 were malignant effusion. Out of total 172 pleural effusions 139 were non neoplastic and 27 neoplastic. Commonest malignancy in peritoneal and pleural fluid was adenocarcinoma from ovary and lung respectively. Conclusions: Cytological evaluation of various fluids is simple, rapid, inexpensive and less invasive tool with high accuracy and thereby reducing the need for invasive investigations. It is especially helpful in evaluating and staging malignancies thereby guiding the clinician in further management.

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Involvement of the cerebrospinal fluid cells in children with acute lymphoblastic leukemia: prognostic implications

Cited by 4 publications

References 18 publications

Central Nervous System Involvement in Childhood Acute Lymphoblastic Leukemia: An Analysis of Day-One Versus Day-Eight Lumbar Punctures in Remission Induction Therapy

Central Nervous System Involvement in Childhood Acute Lymphoblastic Leukemia: An Analysis of Day-One Versus Day-Eight Lumbar Punctures in Remission Induction Therapy

Evaluation of Multiplexed Biomarkers in Assessment of CSF Infiltration in Pediatric Acute Lymphoblastic Leukemia

Exfoliative cytology of different body fluids- an important aid to primary diagnosis

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