Modern methods of investigation of the central nervous system – computerized tomography, magnetic-resonance imaging tomography – have good diagnostic value, especially for revealing brain tumors. However, a high proportion of false results (30-58%) in acute lymphoblastic leukemia (ALL), neuroleukemia (NL) does not allow to focus on modern instrumental neuroimaging (NV). Therefore, the old routine method of NL diagnostics – lumbar puncture – is acquiring a new modern practical value, because diagnostics of NL is necessary in the early stages of treatment, during the 1st week of induction therapy, for revealing such an important risk factor as initial NL and for determining an appropriate approach in the volume of high-dosage therapy. Early diagnostics of initial NL determine the indications for cranial irradiation and rate of radial exposition. Timely selected tactics and strategy for treating ALL and INL contribute to the increase in survival and recovery of ill children. Therefore, lumbar puncture continues to be the only diagnostic and treatment method for ALL and NL. Therefore, the biomarker panel of the CSF can be useful in the treatment of ALL and NL. The most commonly used methods of neuroimaging include: MRI, CT with contrast, MR spectroscopy, diffuse-tensor MRI, phlebography. The CSF method used in the study was equivalent to radioactive isotopes and neurospecific proteins of CSF. The studied indicators (concentration of total protein, albumin, globulins, α-amino nitrogen, neuroactive amino acids – glutamic acid, glutamine concentrations) in CSF and blood serum in ALL (status CNS-1) were the following: acute period, remission, bone marrow relapse and developed NL: preclinical and clinical variants of NL (CNS-3), initial NL in children (CNS-6). Concentration gradients of CSF/ serum for albumin, amino nitrogen, glutamic acid, glutamine in various periods of ALL and NL, and in the complication of NL (ST-CNS-3, -6) in children were determined. Cytosis was not always consistent with the clinical presentation. Protocol therapy showed the best survival results. CSF was scanned quickly, the incidence of NL was only 2,4%, as in the original German protocols. 3-component intrathecal therapy (TIT), increased in acute period, and consolidation had better outcomes. The study of the permeability coefficients of the blood-brain barrier in ALL and NL in children demonstrated their prognostic significance (remission, prolonged course, lethal outcome).
Modern methods of investigation of the central nervous system – computerized tomography, magnetic-resonance imaging tomography – have good diagnostic value, especially for revealing brain tumors. However, a high proportion of false results (30-58%) in acute lymphoblastic leukemia (ALL), neuroleukemia (NL) does not allow to focus on modern instrumental neuroimaging (NV). Therefore, the old routine method of NL diagnostics – lumbar puncture – is acquiring a new modern practical value, because diagnostics of NL is necessary in the early stages of treatment, during the 1st week of induction therapy, for revealing such an important risk factor as initial NL and for determining an appropriate approach in the volume of high-dosage therapy. Early diagnostics of initial NL determine the indications for cranial irradiation and rate of radial exposition. Timely selected tactics and strategy for treating ALL and INL contribute to the increase in survival and recovery of ill children. Therefore, lumbar puncture continues to be the only diagnostic and treatment method for ALL and NL. Therefore, the biomarker panel of the CSF can be useful in the treatment of ALL and NL. The most commonly used methods of neuroimaging include: MRI, CT with contrast, MR spectroscopy, diffuse-tensor MRI, phlebography. The CSF method used in the study was equivalent to radioactive isotopes and neurospecific proteins of CSF. The studied indicators (concentration of total protein, albumin, globulins, α-amino nitrogen, neuroactive amino acids – glutamic acid, glutamine concentrations) in CSF and blood serum in ALL (status CNS-1) were the following: acute period, remission, bone marrow relapse and developed NL: preclinical and clinical variants of NL (CNS-3), initial NL in children (CNS-6). Concentration gradients of CSF/ serum for albumin, amino nitrogen, glutamic acid, glutamine in various periods of ALL and NL, and in the complication of NL (ST-CNS-3, -6) in children were determined. Cytosis was not always consistent with the clinical presentation. Protocol therapy showed the best survival results. CSF was scanned quickly, the incidence of NL was only 2,4%, as in the original German protocols. 3-component intrathecal therapy (TIT), increased in acute period, and consolidation had better outcomes. The study of the permeability coefficients of the blood-brain barrier in ALL and NL in children demonstrated their prognostic significance (remission, prolonged course, lethal outcome).