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Cranial computerized tomography and cerebrospinal fluid procoagulant activity in childhood acute lymphoblastic
A E O'Hare1, O B Eden, R M Simpson
1Department of Child Life and Health, University of Edinburgh, Scotland.
Insights
Cerebrospinal fluid procoagulant activity (PCA) temporarily rose during acute lymphoblastic leukemia (ALL) treatment and later, suggesting it is not specific to myelin disturbance in children.
Area of Science:
- Neuroscience
- Pediatric Oncology
- Biochemistry
Background:
- Acute lymphoblastic leukemia (ALL) treatment can affect the central nervous system (CNS).
- Cerebrospinal fluid procoagulant activity (PCA) is a marker that may indicate CNS disturbance.
- The specificity of PCA elevation in ALL patients, particularly concerning myelin disturbance, requires further investigation.
Purpose of the Study:
- To investigate the temporal changes in cerebrospinal fluid procoagulant activity (PCA) in children with acute lymphoblastic leukemia (ALL).
- To compare PCA levels in ALL patients with those in control groups, including neurologically normal children and those with various neurological disorders.
- To determine if PCA elevation in ALL is specific to myelin disturbance.
Main Methods:
- Serial cranial computerized tomography (CCT) and cerebrospinal fluid (CSF) procoagulant activity (PCA) measurements were performed in 33 children with ALL over 5 years.
- PCA levels were also assessed in control children without neurological disease and in children with diverse neurological conditions.
- Correlation between CCT findings, treatment phases, and PCA levels was analyzed.
Main Results:
- A temporary increase in CSF PCA was observed during prophylactic CNS treatment in children with ALL.
- A secondary rise in CSF PCA was noted 2-3 years after treatment cessation in ALL patients.
- Elevated CSF PCA was also found in neurologically abnormal children following CNS disturbances, indicating PCA elevation is not exclusive to myelin issues.
Conclusions:
- Cerebrospinal fluid procoagulant activity (PCA) exhibits dynamic changes during and after acute lymphoblastic leukemia (ALL) treatment in children.
- The observed elevation of PCA in ALL patients is not specific to myelin disturbance, as similar elevations occur in other CNS conditions.
- Further research is warranted to elucidate the precise role and implications of PCA in pediatric neurological disorders and ALL treatment.
Abstract:
Thirty-three children with acute lymphoblastic leukemia (ALL) were studied using serial cranial computerized tomography (CCT) and cerebrospinal fluid procoagulant activity (PCA) for 5 years from the time of diagnosis. PCA was also studied in control children without neurological disease and in those with a variety of neurological disorders. Temporary elevation in the CSF PCA was observed during the phase of prophylactic central nervous system treatment in ALL and there was a late rise at 2-3 years off treatment. PCA also rose in the CSF following CNS disturbance in neurologically abnormal children, which suggests that the elevation observed in ALL is not specific to myelin disturbance.
