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Cleaved L-selectin concentrations in meningeal leukaemia
Journal Article Research Support, Non-U.S. Gov't --- Old month value: Feb 4
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.
Adult Cell Adhesion Molecules/blood/*cerebrospinal fluid Humans L-Selectin Leukemia, Lymphocytic, Acute, L2/blood/*cerebrospinal fluid/pathology Leukemia, Myelocytic, Acute/blood/cerebrospinal fluid/pathology Leukemia, Myeloid, Chronic/blood/cerebrospinal fluid/pathology Leukemic Infiltration/blood/cerebrospinal fluid/*diagnosis Meninges/*pathology Receptors, Lymphocyte Homing/*analysis
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