Significance of blasts in low‐cell‐count cerebrospinal fluid specimens from children with acute lymphoblastic leukemia
Significance of blasts in low‐cell‐count cerebrospinal fluid specimens from children with acute lymphoblastic leukemia
复制标题
急性淋巴细胞白血病儿童低细胞计数脑脊液标本中原始细胞的意义
作者：
L. Odom;H. Wilson;J. Cullen;Joann Bank;M. Blake;B. Jamieson
本研究的目的是确定急性淋巴细胞白血病（ALL）患儿脑脊液（CSF）中白细胞分类计数低于6个/μl的原始细胞超过5%是否预示中枢神经系统（CNS）复发。本文采用双浓缩细胞离心法对1982年1月1日至1988年9月30日期间349例急性淋巴细胞白血病患儿的4543份连续脑脊液标本进行了分析。来自58例可评价儿童的109份CSF标本的细胞离心分类计数低于6个白细胞/μl，原始细胞超过5%（低细胞计数标本，含原始细胞[LCB]）。在研究期间，332名可评估儿童中有25名（7.5%）出现CNS白血病复发。在22/25例（88%）中，CNS复发之前至少有一份异常低细胞计数CSF标本。34例诊断时患有单一LCB的患者中有1例（3%）随后发生CNS复发，而缓解期间患有单一LCB的8例患者中有5例（62.5%）发生CNS复发（P = 0.0002）。在缓解期有两个或两个以上LCB的16名儿童中，9名（56%）根据标准标准定义为CNS复发，而该组中另外6名患者根据其重复LCB被宣布为CNS复发。基于CNS白血病定义的修改，在病程早期诊断CNS复发是否会改变随后不良事件的频率或可能降低CNS再治疗的强度仍有待确定。
The purpose of this study was to determine whether the presence of more than 5% blasts in a differential count of cytocentrifuged cerebrospinal fluid (CSF) with less than 6 leukocytes/μl was predictive of central nervous system (CNS) relapse in children with acute lymphoblastic leukemia (ALL). A double concentrate method of cytocentrifuge preparation was used to analyze 4543 consecutive CSF specimens from 349 children with ALL between January 1, 1982, and September 30, 1988. One hundred nine CSF specimens from 58 evaluable children had less than 6 leukocytes/μl and more than 5% blasts on cytocentrifuge differential count (low‐cell‐count specimen with blasts [LCB]). During the study period, 25 of 332 evaluable children (7.5%) had CNS leukemic recurrence. In 22 of 25 (88%), the CNS relapse was preceded by at least one abnormal low‐cell‐count CSF specimen. One of 34 patients with a single LCB at diagnosis (3%) had subsequent CNS relapse compared with five of eight patients (62.5%) with a single LCB during remission (P = 0.0002). Of 16 children with two or more LCB during remission, nine (56%) had CNS relapse defined by standard criteria, whereas six additional patients in this group were declared to be in CNS relapse on the basis of their repetitive LCB. Whether diagnosing CNS recurrence earlier in its course based on a modification of the definition of CNS leukemia will change the frequency of subsequent adverse events or make possible decreased intensity of CNS retreatment remains to be determined.
影响因子：
45.3
作者：
GEORGE, SL;OCHS, JJ;SIMONE, JV
通讯作者：
SIMONE, JV
儿童急性淋巴细胞白血病治疗的争议：治疗强化、中枢神经系统白血病和预后因素。
影响因子：
3.6
作者：
Rivera,GK;Mauer,AM
通讯作者：
Mauer,AM