Questioning the need for routine bone marrow aspiration and lumbar puncture in patients with retinoblastoma
| Autor: | Luciano Dalla-Pozza, Domit Azar, Craig Donaldson |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty Retinal Neoplasms Enucleation Diagnostic Techniques Ophthalmological Malignancy Spinal Puncture Bone Marrow Biopsy Humans Medicine Neoplasm Staging medicine.diagnostic_test Diagnostic Tests Routine business.industry Retinoblastoma Lumbar puncture Biopsy Needle Infant Bone Marrow Examination medicine.disease Surgery Bone marrow examination Ophthalmology medicine.anatomical_structure Female Bone marrow Safety business |
| Zdroj: | Clinical and Experimental Ophthalmology. 31:57-60 |
| ISSN: | 1442-9071 1442-6404 |
| DOI: | 10.1046/j.1442-9071.2003.00601.x |
| Popis: | Purpose: This study assesses the value of routinely investigating children with retinoblastoma with bone marrow aspiration and lumbar puncture, staging investigations not without risk and trauma to the patient, emotional stress on parents and financial cost to the community. Methods: Medical files and specimens were obtained and examined for patients with retinoblastoma presenting to the Royal Alexandra Hospital for Children, Camperdown and the Children's Hospital at Westmead, Sydney, from 1975 to 2001. Results: In total, 123 patients presented; 62 (50.4%) were boys and 61 (49.6%) were girls. Of these 123 patients, 74 (60.2%) had unilateral disease, 46 (37.4%) involving the left eye and 28 (22.8%) involving the right eye. There were 47 (38.2%) patients with bilateral disease, and two (1.6%) with trilateral disease. Mean age of presentation was 17.9 months (23.1 months for unilateral subjects; 10.3 months for bilateral subjects; 3.5 months for trilateral subjects). There were 13 (10.6%) with a positive family history. Of 74 unilateral subjects, 70 (94.6%) required enucleation and four (5.4%) were salvaged. Of 47 bilateral subjects, 13 (27.7%) did not require enucleation, 27 (57.4%) required unilateral enucleation and seven (14.9%) required bilateral enucleation. Both trilateral subjects died. Of all 123 subjects, 112 (91.1%) had bone marrow aspiration and lumbar puncture performed during initial assessment, and none showed evidence of malignancy. Conclusions: Given the small but significant risks associated with these procedures, the results of this study cannot support bone marrow aspiration and lumbar puncture as routine investigations in all patients presenting with retinoblastoma, suggesting a more limited usage of these investigations is warranted. |
| Databáze: | OpenAIRE |
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