To delay or not to delay, that is the question for patients with acute lymphoblastic leukemia who do not receive prophylactic cranial irradiation.

Abstract

To determine the impact of delaying diagnostic lumbar puncture and initial intrathecal therapy on treatment outcome of children with newly diagnosed acute lymphoblastic leukemia (ALL) treated without prophylactic cranial irradiation, Yeh and colleagues updated their TPOG-ALL-2002 clinical trial. They found that this treatment strategy reduced the rate of traumatic lumbar puncture with blasts to zero, and tended to improve outcome of patients with a CNS-2 or CNS-3 status based on the event-free survival, the overall survival, and the cumulative risk of CNS relapse, as compared to historical controls.