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The platelet count threshold at which lumbar puncture (LP) can safely be performed is not known. These authors analyzed the records of 956 consecutive children (median age, 5.5 years) with recently diagnosed acute lymphoblastic leukemia who underwent LP at a single cancer center between 1984 and 1998.
No neurologic, infectious, or hemorrhagic complications occurred in any of the 5223 LPs (95 percent CI for the probability of serious complications, 0.00 percent -0.07 percent), including 941 performed in patients with platelet counts at or below 50X109/L. Among the 199 LPs performed in patients with severe thrombocytopenia (platelet counts at or below 20X109/L), the 95 percent CI for the probability of serious complications was 0.00 percent -1…