title: Fibronectin concentration in cerebrospinal fluid reflects early central nervous system involvement in children with acute lymphoblastic leukemia.
abstract: We measured concentrations of fibronectin (FN) in the cerebrospinal fluid (CSF) in long-term follow-up patients with acute lymphoblastic leukemia (ALL). In 11 patients with neuroleukemia the CSF-FN level was elevated already at the time of diagnosis of ALL, 3.8 +/- 0.6 mg/l, increased during therapy to 4.7 +/- 0.5 mg/l, and at the time of concurrent blast cell finding it was 5.5 +/- 1.0 mg/l. In 11 patients with no subsequent CNS leukemia, the mean CSF-FN level was 2.4 +/- 0.6 mg/l at the time of diagnosis of ALL and 2.8 +/- 0.6 mg/l during therapy, and increased to 3.2 +/- 0.8 mg/l. The neuroleukemia rate was 43% in patients with initial CSF-FN levels greater than 2 mg/l, compared with 5% in patients with CSF-FN levels less than or equal to 2 mg/l (p less than 0.005) in a group of 45 long-term follow-up patients with ALL. Regression analysis on the 21 clinical or laboratory parameters studied showed that the only variable independently associated with CSF-FN was the total protein concentration in the CSF; this, however, explained only 14% of the observed variation in the CSF-FN concentration and did not show any correlation with CNS involvement. We conclude that the CSF-FN test at diagnosis of ALL showed significant differences between groups of patients with and without CNS leukemia, and may prove to be a new early marker for neuroleukemia.
authors.affiliation: Children's Hospital, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Koskiniemi
authors.forename: J
authors.initials: J
authors.lastname: Rajantie
authors.forename: J
authors.initials: J
authors.lastname: Rautonen
authors.forename: M L
authors.initials: ML
authors.lastname: Laipio
authors.forename: E M
authors.initials: EM
authors.lastname: Salonen
authors.forename: M A
authors.initials: MA
authors.lastname: Siimes
authors.forename: A
authors.initials: A
authors.lastname: Vaheri
mesh_terms: D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000134:cerebrospinal fluid*; D001932:Brain Neoplasms / Q000175:diagnosis*; D016009:Chi-Square Distribution; D002675:Child, Preschool; D005260:Female; D005353:Fibronectins / Q000134:cerebrospinal fluid*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis*; D011379:Prognosis; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000175:diagnosis*
chemical_list: D014408:Biomarkers, Tumor; D005353:Fibronectins