Abstract:OBJECTIVE: To explore the changes and significance of tumor necrosis factor alpha (TNF α) in the serum and cerebrospinal fluid (CSF) of children with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Methods TNF α was measured by radioimmunoassay in 31 cases of childhood acute leukemia of various phases. RESULTS: Serum TNF α levels pre therapy in ALL and AML [( 24.35 ± 4.84 ) pmol/L, ( 28.65 ± 5.12 ) pmol/L] were significantly higher than that of control [( 11.28 ± 1.69 ) pmol/L], P< 0.01 . Right after complete remission (CR), TNF α decreased [( 16.42 ± 2.57 ) pmol/L, ( 14.57 ± 3.64 ) pmol/L] but was higher than that of control (P< 0.05 ). 6, 12, 24, 36 months after CR, serum TNF α levels in ALL and AML returned to normal. Serum TNF α increased again and was higher than that of control (P< 0.01 ) when relapsed. CSF TNF α pre therapy in ALL and AML [( 12.35 ± 1.74 ) pmol/L, ( 14.56 ± 1.92 ) pmol/L] were also significantly higher than that of control [( 7.54 ± 0.96 ) pmol/L] (P< 0.01 ). During CR and continuous CR, CSF TNF α in ALL and AML patients remained at the level of control (P> 0.05 ). CSF TNF α level in children with central nervous system leukemia (CNSL) was higher than those without CNSL [( 25.62 ± 7.14 pmol/L vs ( 12.15 ± 0.89 ) pmol/L], P< 0.01 . There was a positive correlation between white blood cell count and TNF α level in the CSF (r= 0.942 , P< 0.05 ). CSF TNF α level decreased gradually after intrathecal therapy, but it decreased more slowly than the white blood cells of CSF. CONCLUSIONS: TNF α concentration in the serum and CSF may be of great value in reflecting leukemic cell burden, early diagnosis of CNSL and monitoring intrathecal chemotherapy.
