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Central Nervous System Relapse Surveillance by Serial Beta 2 ‐Microglobulin Measurements in Childhood Acute Lymphoblastic Leukemia
Author(s) -
CLAUSEN N.,
IBSEN K. K.
Publication year - 1984
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1984.tb17786.x
Subject(s) - medicine , cerebrospinal fluid , beta 2 microglobulin , central nervous system , acute lymphocytic leukemia , lymphoblast , gastroenterology , lymphoblastic leukemia , leukemia , induction therapy , immunology , chemotherapy , biology , genetics , cell culture
. Beta 2 ‐microglobulin (β 2 m) is synthesized particularly in lymphocytes. Its value for early detection of central nervous system (CNS) involvement in acute lymphoblastic leukemia in children was tested by serial determinations. Before 9 overt CNS relapses, the mean increase of the cerebrospinal fluid (CSF) β 2 m concentration was 588 μg/l/month (range: ‐50 to +2020), which was significantly higher than the steady levels during maintenance treatment. Although the absolute value of CSF β 2 m was increased to 1430 μg/l in the group with overt CNS relapse, individual variations in CSF β 2 m before a relapse were so great that no difference was seen between samples from CSF with or without lymphoblasts. The ratio between β 2 m in the CSF and in serum did not increase in serial samples prior to overt relapse, but the ratio was higher in patients with CNS relapse compared with a control group on maintenance therapy. In 9 children without CNS leukemia, the β 2 m concentration in CSF and serum decreased to a nadir 4 weeks after the start of induction treatment. The subsequent increase of CSF β 2 m was similar to the increase before a CNS relapse. Mean values of CSF β 2 m changes differed between groups of children with and without CNS leukemia early in the induction phase and during the maintenance treatment, but the wide range in individual values made serial β 2 m determinations unsuitable for detecting a CNS relapse.