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Cancer Seeding Risk from an Epidural Blood Patch in Patients with Leukemia or Lymphoma
Christopher J Demaree1, Jose M Soliz2, Rodolfo Gebhardt1
1Departments of Pain Medicine, University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
Pain Medicine (Malden, Mass.)
|August 26, 2016
Summary
Epidural blood patches (EBPs) are safe for treating postdural puncture headaches in cancer patients. This study found no instances of cancer seeding in leukemia or lymphoma patients who received EBPs.
Area of Science:
- Neurology
- Oncology
- Anesthesiology
Background:
- Lumbar punctures are common in cancer patients.
- Postdural puncture headaches are a potential complication.
- Concerns exist regarding epidural blood patches (EBPs) and neoplastic seeding in cancer patients.
Purpose of the Study:
- To evaluate the risk of central nervous system cancer seeding after epidural blood patches (EBPs) in patients with leukemia or lymphoma.
Main Methods:
- Retrospective study of institutional electronic records from 2000-2013.
- Identified patients with leukemia/lymphoma who received at least one EBP.
- Reviewed records for demographic data, cancer treatments, mortality, and evidence of new central nervous system neoplastic seeding post-EBP.
Main Results:
- Eighty patients (18 leukemia, 62 lymphoma) were included.
- None of the patients experienced new cancer or central nervous system seeding after an EBP.
- Median follow-up was 3.74 years.
Conclusions:
- Epidural blood patches (EBPs) have a low risk of causing cancer seeding in the central nervous system.
- EBPs are a viable treatment option for postdural puncture headaches in cancer patients unresponsive to conservative management.
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