Miconi Cléofé, Maître Elsa, Allouche Stéphane, Brunel Valéry, Bera Elsa, Buchonnet Gérard, Deparis Marianna, Schneider Pascale, Rouger Jérémie
Pediatric Oncology and Hematology, Caen University Hospital, Avenue de La Côte de Nacre, 14000, Caen, France.
Laboratory of Hematology, Caen University Hospital, Caen, France.
Eur J Pediatr. 2025 Jan 20;184(2):148. doi: 10.1007/s00431-025-05986-0.
Biochemical analyses of cerebrospinal fluid (CSF) are routinely performed at diagnosis in many pediatric oncology and hematology centers when acute leukemia is diagnosed. However, the clinical relevance of these analyses remains unclear. We conducted a retrospective analysis of biochemical CSF data from children diagnosed with acute leukemia at two French hospitals between 2016 and 2023 assessing the results in relation to the presence or absence of leukemic neuromeningeal involvement and the correlation between cytological and biochemical analyses. On 151 patients, 13 had a central nervous involvement (CNS), only one with neurological symptoms. All our patients had a biochemical analysis of CSF at diagnosis. We did not find any strong correlation (p < 0.05) between cytological studies and biochemical analysis in CSF.
Without therapeutic impact, we conclude that routine measurement of biochemical analysis in the CSF is not indicated in children with acute leukemia.
• Biochemical analysis of the cerebrospinal fluid (CSF) is routinely performed in children with acute leukemia in some centers while its clinical value remains uncertain. • Cytology is the gold standard technique for the detection of central nervous system (CNS) involvement in leukemia.
• No significant correlation was found between CSF biochemical and cytological analyses and CSF biochemical analysis had no added clinical value in this study. • Our results suggest that routine CSF biochemical analysis may be omitted in this clinical context.
在许多儿科肿瘤学和血液学中心，当诊断出急性白血病时，脑脊液（CSF）的生化分析在诊断时常规进行。然而，这些分析的临床相关性仍不明确。我们对2016年至2023年期间在两家法国医院被诊断为急性白血病的儿童的脑脊液生化数据进行了回顾性分析，评估了与白血病性脑脊膜受累情况相关的结果以及细胞学和生化分析之间的相关性。在151例患者中，13例有中枢神经系统受累（CNS），只有1例有神经系统症状。我们所有患者在诊断时都进行了脑脊液生化分析。我们未发现脑脊液细胞学研究与生化分析之间有任何强相关性（p < 0.05）。
由于没有治疗影响，我们得出结论，急性白血病患儿不建议常规进行脑脊液生化分析。
• 在一些中心，急性白血病患儿常规进行脑脊液（CSF）生化分析，但其临床价值仍不确定。• 细胞学是检测白血病中枢神经系统（CNS）受累的金标准技术。
• 在本研究中，脑脊液生化分析与细胞学分析之间未发现显著相关性，脑脊液生化分析没有额外的临床价值。• 我们的结果表明，在这种临床情况下，可省略常规脑脊液生化分析。
