Case series: CSF LDH, proteins and electrolyte levels in patients of acute lymphocytic leukemia

Rao, D. S. V. Raman; Ghalaut, Veena Singh; Ps, Ghalaut; Rao, Shashi

doi:10.1016/j.cca.2012.02.012

Cited by 6 publications

(6 citation statements)

References 10 publications

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“…In CNSL patients, all of the TJ indexes were significantly lower than in the non‐CNSL patients, demonstrating that the main source of TJs in the CSF of leukaemia patients results from passive influx from the peripheral blood. In leukaemia, MMP‐2, ‐9 and VEGF secreted by leukemic cells degrade ZO‐1, CLDN5 and OCLN and constitute an important mechanism of the BBB breakdown . MMP‐9 could originate from the choroid plexus , in which MMP‐9 degrade local TJs.…”

Section: Discussionmentioning

confidence: 99%

“…Nowadays, the cytological examination of cerebrospinal fluid (CSF) is still the gold standard for leukemic meningitis's diagnosis . If CSF specimens only contain few malignant cells, cytologists hardly render a definitive diagnosis . Our previous data showed that higher levels of VEGF‐A and MMP‐9 in CSF promoted BBB breakdown that were closely related to leukaemia CNS metastasis .…”

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confidence: 99%

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Circulating tight junction proteins mirror blood-brain barrier integrity in leukaemia central nervous system metastasis

Zhu

et al. 2016

Hematological Oncology

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The aim of this study was to evaluate the clinical significance of circulating tight junction (TJ) proteins as biomarkers reflecting of leukaemia central nervous system (CNS) metastasis. TJs [claudin5 (CLDN5), occludin (OCLN) and ZO-1] concentrations were measured in serum and cerebrospinal fluid (CSF) samples obtained from 45 leukaemia patients. Serum ZO-1 was significantly higher (p < 0.05), but CSF ZO-1 levels were not significantly higher in the CNS leukaemia (CNSL) compared to the non-CNSL. The CNSL patients also had a lower CLDN5/ZO1 ratio in both serum and CSF than in non-CNSL patients (p < 0.05). The TJ index was negatively associated with WBC , ALB and BBB values in leukaemia patients. Among all of the parameters studied, CLDN5 had the highest specificity in discriminating between CNSL and non-CNSL patients. Therefore, analysing serum and CSF levels of CLDN5, OCLN and the CLDN5/ZO1 ratio is valuable in evaluating the potential of leukaemia CNS metastasis. Copyright © 2016 John Wiley & Sons, Ltd.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Circulating tight junction proteins mirror blood-brain barrier integrity in leukaemia central nervous system metastasis

Zhu

et al. 2016

Hematological Oncology

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“…This phenomenon is likely due to the correlation between LDH levels and the number of circulating ALL blasts during relapse (47). Cumulative evidence indicates that serum LDH levels can be a good and reliable prognostic marker of ALL patients (48)(49)(50), suggesting an association between LDH levels and relapse.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of D-dimer and lactate dehydrogenase plasma levels in patients with relapsed acute leukemia

Wang

Yang

2016

Oncology Letters

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Abstract. Despite the outstanding advances made over the past decade regarding our knowledge of acute leukemia (AL), relapsed AL remains to be associated with a dismal prognosis. A better understanding of AL relapse and monitoring of the D-dimer and lactate dehydrogenase (LDH) plasma levels following chemotherapy may aid clinicians in determining whether relapse may occur in the subsequent phases of the disease. The present study evaluated D-dimer and LDH levels in 204 patients with relapsed AL. Data were collected at the initial onset of AL, at complete remission (CR) and in patients with relapsed AL. D-dimer plasma levels were significantly increased in patients with initial AL and in patients with relapsed AL (P=0.005 and P=0.007, respectively) but not in those with CR. LDH levels were significantly increased in AL patients at the initial onset of disease and at relapse compared with patients achieving CR, irrespective of cell type. Plasma prothrombin time, activated partial thromboplastin time and fibrinogen levels were not significantly different across patients (with the exception of acute promyelocytic leukemia patients) at the initial onset, relapsed AL or CR. Routine hematological parameters (white blood cell count, hemoglobin, platelet count) were significantly different at the initial onset of AL (P=0.002, P<0.001 and P=0.001, respectively) and during relapsed AL (P=0.009, P=0.003 and P<0.001, respectively) compared with patients achieving CR, suggesting an association between D-dimer, LDH and relapsed AL. These results also indicate that determination of D-dimer and LDH levels may be useful for predicting the probability of relapse during chemotherapy, but should also be combined with routine hematological parameters.

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“…Similarly, LDH (EC 1.1.1.27 & EC1.1.1.28), which catalyzes the interconversion of pyruvate and lactate, is ubiquitously released from all cells after damage to the plasma membrane. LDH is thought to be a biochemical index of neuronal cytotoxicity [33] with elevations in a wide array of neurological disorders including meningitis [34], prion disease [35], leukemia [36], trauma [37], infantile spasms [38], stroke [31] and canine GM1 gangliosidosis [21]. LDH has been used to distinguish various neurological disorders [37,39].…”

Section: Discussionmentioning

confidence: 99%

Biomarkers for disease progression and AAV therapeutic efficacy in feline Sandhoff disease

Bradbury

Gray‐Edwards

Shirley

et al. 2015

Experimental Neurology

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The GM2 gangliosidoses, Tay-Sachs disease (TSD) and Sandhoff disease (SD), are progressive neurodegenerative disorders that are caused by a mutation in the enzyme β-N-acetylhexosaminidase (Hex). Due to the recent emergence of novel experimental treatments, biomarker development has become particularly relevant in GM2 gangliosidosis as an objective means to measure therapeutic efficacy. Here we describe blood, cerebrospinal fluid (CSF), magnetic resonance imaging (MRI), and electrodiagnostic methods for evaluating disease progression in the feline SD model and application of these approaches to assess AAV-mediated gene therapy. SD cats were treated by intracranial injections of the thalami combined with either the deep cerebellar nuclei or a single lateral ventricle using AAVrh8 vectors encoding feline Hex. Significantly altered in untreated SD cats, blood and CSF based biomarkers were normalized after AAV gene therapy. Also reduced after treatment were expansion of the lysosomal compartment in peripheral blood mononuclear cells and elevated activity of secondary lysosomal enzymes. MRI changes characteristic of the gangliosidoses were documented in SD cats and normalized after AAV gene therapy. The minimally invasive biomarkers reported herein should be useful to assess disease progression of untreated GM2 patients and those in future clinical trials.

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Case series: CSF LDH, proteins and electrolyte levels in patients of acute lymphocytic leukemia

Cited by 6 publications

References 10 publications

Circulating tight junction proteins mirror blood-brain barrier integrity in leukaemia central nervous system metastasis

Circulating tight junction proteins mirror blood-brain barrier integrity in leukaemia central nervous system metastasis

Evaluation of D-dimer and lactate dehydrogenase plasma levels in patients with relapsed acute leukemia

Biomarkers for disease progression and AAV therapeutic efficacy in feline Sandhoff disease

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