Table 2.

Grading of CNS disease per the COG classification system

Grade of CNS disease at diagnosisDefinition
CNS-1 No blasts in the CSF (regardless of WBC or RBC count in CSF) 
CNS-2  
<5 WBC per μL + blasts + <10 RBC per μL  
<5 WBC per μL + blasts + >10 RBC per μL 
≥5 WBC per μL + blasts + ≥10 RBC per μL; CSF WBC <2 × peripheral blood WBC 
CNS-3  
≥5 WBC per μL + blasts + <10 RBC per μL 
≥5 WBC per μL + blasts + ≥10 RBC per μL; CSF WBC >2 × peripheral blood WBC 
Clinical evidence of CNS disease  
Grade of CNS disease at diagnosisDefinition
CNS-1 No blasts in the CSF (regardless of WBC or RBC count in CSF) 
CNS-2  
<5 WBC per μL + blasts + <10 RBC per μL  
<5 WBC per μL + blasts + >10 RBC per μL 
≥5 WBC per μL + blasts + ≥10 RBC per μL; CSF WBC <2 × peripheral blood WBC 
CNS-3  
≥5 WBC per μL + blasts + <10 RBC per μL 
≥5 WBC per μL + blasts + ≥10 RBC per μL; CSF WBC >2 × peripheral blood WBC 
Clinical evidence of CNS disease  

Table adapted from Winick et al.21 

Constitutes a traumatic LP.

Includes cranial nerve palsies or other overt neurologic deficits not attributable to other causes.

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