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Lumbar spinal fluid collections in children treated with intrathecal chemotherapy: elevated CSF protein as a

Fahd Almanjomi1, Derek Armstrong, Oussama Abla

  • 1Division of Haematology/Oncology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada.

Pediatric Blood & Cancer
|May 6, 2008
PubMed

Insights

Subdural fluid collections can hinder intrathecal chemotherapy delivery in children with acute lymphoblastic leukemia (ALL). Early detection via imaging is crucial to ensure effective central nervous system (CNS) treatment.

Area of Science:

  • Pediatric Oncology
  • Neurology
  • Pharmacology

Background:

  • Intrathecal chemotherapy is vital for treating acute lymphoblastic leukemia (ALL) affecting the central nervous system (CNS).
  • Lumbar puncture (LP) is a common method for administering intrathecal chemotherapy.

Observation:

  • Subdural fluid collections were detected in six children undergoing routine LP for ALL.
  • These collections were associated with elevated cerebrospinal fluid (CSF) protein concentrations.

Findings:

  • Lumbar fluid collections persisted in two of the six cases.
  • One case necessitated an Ommaya reservoir to enable continued intrathecal chemotherapy delivery.

Implications:

  • Subdural fluid collections pose a significant complication for effective intrathecal chemotherapy in ALL patients.
  • Awareness and prompt imaging are essential for managing this complication and ensuring adequate CNS-directed therapy.

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