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Published on: November 29, 2019
Amino acid concentrations in cerebrospinal fluid in children with acute lymphoblastic leukemia undergoing
1Department of Pediatrics, China Medical University Hospital, No. 2, Yuh Der Road, Taichung, Taiwan. pct@www.cmuh.org.tw
Insights
Higher baseline cerebrospinal fluid (CSF) glutamine levels in children with acute lymphoblastic leukemia (ALL) may indicate a greater risk for central nervous system (CNS) leukemia. Further trials are needed to confirm glutamine as a CNS disease marker.
Area of Science:
- Pediatric Oncology
- Neuro-Oncology
- Clinical Chemistry
Background:
- Acute lymphoblastic leukemia (ALL) is a common childhood cancer.
- Central nervous system (CNS) involvement is a significant complication in ALL.
- Cerebrospinal fluid (CSF) analysis is crucial for diagnosing and monitoring CNS disease.
Purpose of the Study:
- To investigate CSF amino acid concentrations in children with ALL.
- To determine if specific amino acid profiles correlate with CNS disease presence.
- To explore potential biomarkers for CNS leukemia risk.
Main Methods:
- CSF samples were collected from 45 children with ALL at diagnosis and during treatment.
- Amino acid concentrations were measured using quantitative analysis.
- A control group of 32 children with febrile convulsions was included for comparison.
Main Results:
- Children with ALL exhibited significantly higher baseline CSF glutamine levels than controls.
- Patients with CNS disease (Group M) had higher glutamine than those without (Group L).
- CSF glutamine and asparagine decreased, while glutamic acid increased in Group L by Day 14; glutamine decreased in Group M by Day 42.
Conclusions:
- Elevated baseline CSF glutamine may serve as an indicator of increased risk for CNS leukemia in ALL patients.
- Glutamine warrants further investigation as a potential biomarker for CNS disease in pediatric ALL.
- Understanding glutamine regulation in ALL could elucidate mechanisms of CNS involvement.
Abstract:
Cerebrospinal fluid (CSF) amino acid concentrations were measured in 45 children with acute lymphoblastic leukemia (ALL). Central nervous system (CNS) disease was absent in 34 and present in 11 (Groups L and M, respectively) at diagnosis. Thirty-two otherwise healthy children with febrile convulsions were studied for comparison. Results from this study show that glutamine levels at Day 0 were significantly higher in patients than in controls. Patients in Group M had elevated glutamine levels compared to Group L. In comparison, at Day 14, concentrations of glutamine and asparagine decreased, while glutamic acid amounts increased significantly in Group L. Glutamine levels fell at Day 42 in Group M, which may have resulted from more intensive treatment. From this study we hypothesise that higher baseline glutamine levels are indicative of a greater risk for CNS leukemia. Large-scale prospective trials are required to confirm increased baseline CSF glutamine levels in ALL patients, to identify glutamine as a marker for CNS disease and to clarify underlying mechanisms regulating glutamine in ALL.
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