Cerebrospinal fluid polyamines in childhood leukemia

Cerebrospinal fluid (CSF) polyamines were measured in children with acute lymphocytic leukemia or non-Hodgkin's lymphoma in various stages of the disease ranging from complete remission to active central nervous system (CNS) involvement. Polyamines were analyzed by ion exchange chromatography with o- pthalaldehyde fluorimetric detection. Putrescine concentrations in random CSF samples obtained from leukemic patients with and without CNS involvement were not significantly different. Spermidine levels were generally higher in patients without CNS leukemia than in patients with the disease. In serial CSF specimens from an individual patient, spermidine levels correlated well with clinical status, being high in the active stages of the disease and low in remission. Thus, CSF polyamines appear to be of limited value as a screening test for early detection of CNS leukemia; however, they may offer an additional means of evaluating CNS leukemia and its response to therapy.