Abstract • 191
The analysis of cerebrospinal fluid (CFS) constitute actually the best method to diagnostic the attack of central nervous system (CNS) in acute lymphoblastic leukemia. The object of the analisys was the alteration of CSF before the infiltration of CNS by leukemia cells in order to determinate a relation between that prior alterations and the CNS relapse. For that purpose, the CSF of 65 patients, aged between 0-18, bearer ALL was studied during april/1993 to december/1998. Of this 65 patients, 43 (66.15%) had neoplastic cells in CSF and 22 (33.84%) never had CNS leukemic infiltrations. Seven (16.27%) of the 43 patients who experienced a CNS relapse had blastic cells only in the first exam, while 36 (83.72%) had at least one neoplastic cells infiltration in CSF during the treatment. In these 36 patients, the alterations of CSF before the CNS infiltration were increase of protein (40.54%), increase of cells (27.02%), low of glucose (10.81%) and increase of cells and protein (16.21%). In order to avaliate the CSF profile, was also analised the CSF alterations of protein, cells and glucose in the three groups of patients: (1) with some infiltrations during the therapy, (2) with only one infiltration in the first exam, (3) without CNS involvement. By comparing this CNS alterations in the referred three groups of patients (1,2 and 3), was observed, respectively: increase of protein (72.22% - 42.85% - 63.63%), increase of cells (77.77% - 42.85% - 54.54%), low of glucose (33.33% - 14.28% - 27.27%) and increase of cells and protein (63.88% - 57.14% - 36.36%). Considering that, the analysis of results evidence that the cells, protein and glucose alterations found in the cerebrospinal fluid of the studied patients do not seem to function as a confiable precocious indicator of the CNS leukemic infiltration.
