Research progress of the central nervous system leukemia in children / 中华实用儿科临床杂志

Acute leukemia (AL) is the most common tumor in childhood.With the improvement of risk stratification therapy, the complete remission rate of AL has been significantly improved.However, central nervous system leukemia (CNSL) remains the major cause of recurrence and death of leukemia.This study aims to review the pathogenesis, diagnosis and treatment of CNSL in children, hoping to further improve the understanding.

Treatment of central nervous system leukemia with CD19-chimeric antigen receptor T-cell immunotherapy: two cases report and literature review / 中华血液学杂志

Objective@#To explore the efficacy and safety of chimeric antigen receptor T (CAR-T) cells in the treatment of central nervous system leukemia (CNSL).@*Methods@#Two leukemia patients with CNSL were treated with CD19-CAR-T cells. The process and results of the entire treatment is reported and related literature review is conducted.@*Results@#The patients were diagnosed as acute myeloid leukemia (AML)-M2 with B lymphoid antigen expression and B cell acute lymphoblastic leukemia(B-ALL) by morphology and immunophenotype assay. The immunophenotype was consistent with the abnormal manifestations of AML-M2 and B-ALL. Their clinical manifestations and laboratory tests met the diagnostic criteria of CNSL. The diagnosis was clear and the two patients were treated with CD19-CAR-T cell immunotherapy. Central nervous system symptoms were relieved. The imaging abnormalities of patient one has disappeared but cytokines release syndrome (CRS) occurred during the treatment. Cerebrospinal fluid of patient two was negative and no obvious CRS reaction was found.@*Conclusions@#CAR-T cell immunotherapy is likely to induce the remission of CNSL and improve the prognosis.

Analysis on clinical features and prognosis in 83 cases of acute lymphoblastic leukemia with central nervous system infiltration / 重庆医学

Objective To investigate the clinical features,treatment regimen and prognosis of acute lymphoblastie leukemia (ALL) complicating central nervous system leukemia (CNSL).Methods The clinical data,results of laboratory detection and imageological examination in the patients with ALL complicating CNSL in this hospital from January 2005 to January 2015 were retrospectively analyzed.Results A total of 83 cases were collected,including 52 male cases(62.65％) and 31 female cases (37.35％) with a median age of 27 (15-72) years old.Among them,19 cases were T cells ALL(T-ALL),54 eases were B cell ALL(B-ALL),3 cases were Burkitt lymphoma/leukemia,2 cases were ALL (T/B lymphocyte) and 5 cases were undefined type.The median follow-up time was 10(1-52) months.The univariate analysis results showed that the patients with high WBC count (WBC≥100× 109) at initial diagnosis or unreach complete remission (CR) after 1 treatment course had relatively poor prognosis.Receiving the radiotherapy could improve the patients' survival rate(P＜0.05).In the multivariate analysis,high WBC count at initial diagnosis was an independent prognostic factor affecting the patients' overall survival(OS) (P=0.007).Conclusion The clinical features in the patients' with ALL complicating CNSL have poor specificity,high WBC level and unreaching CR by 1 treatment course are the poor prognosis factors,and local radiotherapy has a certain significance for prolonging the patients' survival period.

Treatment of central nervous system leukemia with CD19-chimeric antigen receptor T-cell immunotherapy: two cases report and literature review / 中华血液学杂志

Objective: To explore the efficacy and safety of chimeric antigen receptor T (CAR-T) cells in the treatment of central nervous system leukemia (CNSL). Methods: Two leukemia patients with CNSL were treated with CD19-CAR-T cells. The process and results of the entire treatment is reported and related literature review is conducted. Results: The patients were diagnosed as acute myeloid leukemia (AML)-M(2) with B lymphoid antigen expression and B cell acute lymphoblastic leukemia(B-ALL) by morphology and immunophenotype assay. The immunophenotype was consistent with the abnormal manifestations of AML-M(2) and B-ALL. Their clinical manifestations and laboratory tests met the diagnostic criteria of CNSL. The diagnosis was clear and the two patients were treated with CD19-CAR-T cell immunotherapy. Central nervous system symptoms were relieved. The imaging abnormalities of patient one has disappeared but cytokines release syndrome (CRS) occurred during the treatment. Cerebrospinal fluid of patient two was negative and no obvious CRS reaction was found. Conclusions: CAR-T cell immunotherapy is likely to induce the remission of CNSL and improve the prognosis.

The current diagnosis and treatment of central nervous system leukemia / 国际儿科学杂志

Given the existence of the blood brain barrier when combined with chemotherapy in acute leukemia treatment, leukemia cells are ultimately resulted in the occurrence of central nervous system leukemia (CNSL)by escaping the damage of chemotherapy drugs.At present,CNSL diagnostic criteria mainly relies on cerebrospinal fluid examination, clinical presentation and imaging examination.There are many means that contribute to early diagnosis of CNSL, which comprise cerebrospinal fluid cytology, CT and MRI and other imaging, monitoring minimal residual disease (MRD) in cerebrospinal fluid, monitoring hydrogen sulfide in cerebrospinal fluid, testing molecular biomarker indicators.There are several methods of achieving the goal of prevention of CNSL, including direct intrathecal administration of chemotherapy, systemic administration of chemotherapy able to penetrate the blood-brain barrier, and cranial radiation.The treatment of CNSL includes chemotherapy and radiotherapy, allogeneic hematopoietic stem cell transplantation and targeted therapy.

CHANGES AND CLINICAL INDICATIONS OF INTERLEUKIN -2 RECEPTOR, FERRITIN AND FIBRINECTIN IN THE CEREBROSPINAL FLUID OF CENTRAL NERVOUSE SYSTEM LEUKEMIA / 现代医院

Objective To investigate the changes and clinical indications of interleukin-2 receptor, ferritin and fi-brinectin in the cerebrospinal fluid of central nervous system leukemia.Methods ELISA was used to detect the changes of-soluble interleukin-2 receptor, ferritin and fibrinectin in the cerebrospinal fluid of central nervous system leukemia group ( CNSL) and non-CNSL group.Results The concentrations of soluble interleukin-2 receptor, ferritin and fibronectin ince-rebrospinal fluid of the CNSL group were significantly higher than those in non -CNSL group and the control group ( p <0.05).Conclusion The soluble interleukin 2 receptor, ferritin and fibronectin in cerebrospinal fluid are indicative of cen-tral nervous system leukemia.The result suggests that combined detection is important in early diagnosis of central nervous system leukemia.

Cerebrespinal fluid ferritin in the child patients with acute lymphatic leukemia / 实用儿科临床杂志

Objcetives To sparch for the change of cerebrospinal fluid ferritin (CSF-Ft) content and its clinical significance.Methods The 42 patients with acute lymphatic leukemia(ALL)diagnosed by bone marrow biopsy were divided into 3 groups. There were 14 cases in Ⅰ group [introduced therapy stage without central nervous system leukemia(CNSL)7, 24 cases in Ⅱgroup (complete remission stage without CNSL) and 18 cases in Ⅲ grotip (with CNSL). There were 17 patients with viral encephalitis in viral encephalitis group and 15 patients without central nervous system oisease in control group. The CSF-Ft and SFt were determined by radioimmunoassay.Results The CSF-Ft contents of Ⅰ、Ⅱ、Ⅲ 、viral encepbalitis and control groups are 7.03 ?2.21 ?g/L,6.75 ?1.94?g/L, 31.06 ? 8.85?g/L, 7.26?1.83?g/L and 6.52 ?1.57?g/L. The CSF-Ft content in Ⅲ group are bigher than that in the other group (P

Changes of tumor necrosis factor-? levels in serum and cerebrospinal fluid of childhood acute leukemia before and after treatment / 实用儿科临床杂志

Objective To explore the changes of tumor necrosis factor-?(TNF-?) in serum and cerebrospinal fluid(CSF) of children with acute lymphoblastic leukemia (ALL) and acute myelogenous leukemia(AML) and its clinical significance.Methods TNF-? in serum and CSF were measured by radioimmunoassay and CSF samples were obtained from 31 cases of childhood acute leukemia before treatment, on complete remission(CR), and continuous CR.Results Serum TNF-? was in ALL and AML before treatment [(24.35?4.84) pmol/L and(28.65?5.12) pmol/ L],which were significantly higher than those of healthy controls[(11.2 8? 1.69) pmol/L, P

Clinical Investigation of Fundus Fluoroangiography for 30 Cases of Leukemia / 昆明医科大学学报

The results of fundus fluoroangiography for 30 cases with leukemia showed that the incidence of leukemic ophtalmopathy in these patients was 86.7%.It was mainly caused by the infiltration of diseased leukoeytes and was parallel to the incidence of central-nervous-system leukemia.The lesions of leukemic ophthalmopathy were as follows:fundus capillarcetasia seen in 20 cases,making up 66%;veinletectasia in 11 cases,36.6%;fluorotranslucence(absence of chromoepithelia)in 11 cases, 36.6%;fluorocover-up from bleeding in 8 cases,26.6%;optic papilla edema in 3 cases,10%.

Diagnosis of Central Nervous system Leukemia / 昆明医科大学学报

The routine, biochemical, cytological examinations of cerebrospinal fluid (CSF) and electroencephalography were made for 87 cases with acute leukemia. Combining with the clinical findings in the patients, the valuas of using the above tests in diagnosis of central nervous system leukemia (CNS—L) were discussed.It is suggested that tests related to CNS—L should be performed for all patients with acute leukemia, so as to diagnose CNS— L early, treat it in time, elevate the rate of remission and prolong the survival term.