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International Journal of Hematology-Oncology and Stem Cell Research، جلد ۱۳، شماره ۳، صفحات ۱۴۶-۱۵۲
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عنوان انگلیسی Impact of Obesity on Lumbar Puncture Outcomes in Adults with Acute Lymphoblastic Leukemia and Lymphoma: Experience at an Academic Reference Center
چکیده انگلیسی مقاله Background: Lumbar puncture (LP) is a hematology procedure that can require repeated attempts leading to traumatic LP (TLP), which has been related to the central nervous system (CNS) relapse. LP success can depend on the size and anatomy of the patient and the skill of the hematologist. The main objective was to determine the influence of body mass index (BMI) on LP outcomes. Materials and Methods: Adults with lymphoid malignancies requiring LP were included prospectively over one year; hematology residents performed most procedures. A 22-gauge Quincke needle was employed. Comparison between non-traumatic vs. traumatic LPs according to BMI, CNS relapse, and residents’ year was performed. Results: Fifty-four patients with a mean age of 31.5±15.57 years were included. Diagnosis was Acute Lymphoblastic Leukemia-B (74%), Acute Lymphoblastic Leukemia-T (13%) and Non-Hodgkin Lymphoma (13%). 227 LPs were performed, 121 (53.3%) successful, 98 (43.2%) traumatic, 11 (11.2%) TLPs were macroscopically detectable and 87 (88%) microscopic; 8 (3.5%) were dry-taps. Median time between punctures was 11 days (1-202). Median BMI was 25 (22.8-39.6). Main indication for LP was prophylactic (74.5%); 39.2% were performed by first-year, 35.2% by second-year, 19.6% by third-year hematology residents. No difference (p = 0.145) for a TLP was found among residents. A BMI ≥30 (p = 0.040), non-palpable intervertebral space (p = 0.001) and more than one attempt (p = 0.001) were significant for TLP. TLP was not associated with CNS relapse (p = 0.962). Conclusion: Obesity predicted a TLP. A traumatic puncture did not increase the risk of CNS relapse at one-year follow-up.
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نویسندگان مقاله | José Carlos Jaime-Pérez
Department of Hematology, Internal Medicine Division, Dr. José E. González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, Mexico


| Guillermo Sotomayor-Duque
Department of Hematology, Internal Medicine Division, Dr. José E. González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, Mexico


| Patrizia Aguilar-Calderón
Department of Hematology, Internal Medicine Division, Dr. José E. González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, Mexico


| Lorena Salazar-Cavazos
Department of Hematology, Internal Medicine Division, Dr. José E. González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, Mexico


| David Gómez-Almaguer
Department of Hematology, Internal Medicine Division, Dr. José E. González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, Mexico
نشانی اینترنتی http://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1039
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