title: Cleaved L-selectin concentrations in meningeal leukaemia.
abstract: Involvement of the central nervous system has important therapeutic implications in acute leukaemia. Because the identification of blast cells in cerebrospinal fluid (CSF) is often difficult, there is a need for sensitive markers of leukaemic infiltration. Since the shed form of L-selectin (sL-selectin) is frequently increased in acute leukaemia (sL-selectin+ leukaemia), we examined whether assay of sL-selectin in CSF could improve our ability to detect such meningeal involvement. CSF sL-selectin was significantly (p < 0.001) higher in 15 patients with sL-selectin+ meningeal leukaemia (median 60 ng/mL, range 34-150) than in 20 patients with acute leukaemia without meningeal involvement (12 ng/mL, 1-39) or 88 control patients (14 ng/mL, 0-37). Serial measurements of sL-selectin in patients with sL-selectin+ leukaemic meningitis showed increased CSF concentrations of the cleaved receptor in 4 patients with therapy-resistant meningeal leukaemia and sustained normal concentrations in 9 patients in remission. Our results suggest that CSF sL-selectin may be a useful marker in the detection of meningeal involvement by blast cells in patients with sL-selectin+ leukaemia.
authors.affiliation: Division of Haematology, University of Lausanne, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Stucki
authors.forename: A S
authors.initials: AS
authors.lastname: Cordey
authors.forename: N
authors.initials: N
authors.lastname: Monai
authors.forename: J C
authors.initials: JC
authors.lastname: de Flaugergues
authors.forename: M
authors.initials: M
authors.lastname: Schapira
authors.forename: O
authors.initials: O
authors.lastname: Spertini
mesh_terms: D000328:Adult; D015815:Cell Adhesion Molecules / Q000097:blood / Q000134:cerebrospinal fluid*; D006801:Humans; D019041:L-Selectin; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood / Q000134:cerebrospinal fluid / Q000473:pathology; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000134:cerebrospinal fluid / Q000473:pathology; D017254:Leukemic Infiltration / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D008578:Meninges / Q000473:pathology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000134:cerebrospinal fluid* / Q000473:pathology; D016201:Receptors, Lymphocyte Homing / Q000032:analysis*
chemical_list: D015815:Cell Adhesion Molecules; D016201:Receptors, Lymphocyte Homing; D019041:L-Selectin