Colunga-Pedraza Julia Esther, Colunga-Pedraza Perla Rocío, Benavides-López Hilda Valeria, Mares-Gil José Eduardo, Jimenez-Antolinez Yajaira Valentine, Mancías-Guerra Consuelo, Velasco-Ruiz Ileana Yazmín, González-Llano Oscar
Hospital Universitario "Dr. José Eleuterio Gonzalez", Nuevo León, México.
Hospital Universitario "Dr. José Eleuterio Gonzalez", Nuevo León, México.
Hematol Transfus Cell Ther. 2023 Jul;45 Suppl 2(Suppl 2):S25-S29. doi: 10.1016/j.htct.2021.09.018. Epub 2021 Dec 22.
Intrathecal chemotherapy is a mainstay component of acute lymphoblastic leukemia treatment. In Mexico, there is a considerable practice variability in aspects, such as the manner of preparation and the administration technique.
Our objective was to describe the different techniques used for the application of ITC and review the existing recommendations in the literature.
A cross-sectional, nationwide survey study was conducted by an electronic questionnaire sent to hematologists and oncologists in Mexico. We collected demographic data, personal experience, intrathecal chemotherapy techniques, drug preparation and postprocedural conduct.
We received 173 responses. Twenty percent had an anesthesiologist administering sedation and pain management. The platelet count considered safe was 50 × 10/L in 48% of the participants. In 77% (n = 133) of the cases, the conventional needle with stylet used was, 49% did not receive any added diluent in the intrathecal chemotherapy and only 42% were recommended to rest in a horizontal position for more than 30 min.
We identified a considerable variation in the administration of intrathecal chemotherapy across the hematologists in Mexico. We discuss the implications and opportunities in reducing the variation in our setting, highlighting the unmet need to establish guidelines that should be evaluated by the Mexican professional society to produce a position paper regarding practice standardization.
鞘内化疗是急性淋巴细胞白血病治疗的主要组成部分。在墨西哥，鞘内化疗在制备方式和给药技术等方面存在相当大的实践差异。
我们的目的是描述鞘内化疗应用的不同技术，并回顾文献中的现有建议。
通过向墨西哥血液科医生和肿瘤科医生发送电子问卷进行了一项全国性的横断面调查研究。我们收集了人口统计学数据、个人经验、鞘内化疗技术、药物制备和术后行为。
我们收到了173份回复。20%的人有麻醉医生进行镇静和疼痛管理。48%的参与者认为安全的血小板计数为50×10⁹/L。在77%（n = 133）的病例中，使用的是带针芯的传统针头，49%的人在鞘内化疗中未接受任何添加稀释剂，只有42%的人被建议平躺超过30分钟。
我们发现墨西哥血液科医生在鞘内化疗给药方面存在相当大的差异。我们讨论了在我们的环境中减少差异的影响和机会，强调了建立指南的未满足需求，墨西哥专业协会应评估这些指南以制定关于实践标准化的立场文件。
