Correlation of cerebrospinal fluid beta-glucuronidase activity with plasma XXXX concentrations in leukemic @entity1 receiving high-dose @entity1499 .

@entity1 @entity32 @entity981 @entity11108 @entity1500 @entity1499 @entity2359
BACKGROUND: The activity of lysosomal enzymes is increased in body fluids during @entity32 , in which cellular malfunction and cellular death occurs. Because chemotherapy also causes cell malfunction and death, for identifying a neurologic effect, we studied the activity of beta-glucuronidase in the cerebrospinal fluid (CSF) of leukemic @entity1 during treatment. PROCEDURE: The beta-glucuronidase activity in CSF was determined in 13 @entity1 with B-precursor @entity981 ( @entity981 ) treated with the medium risk arm of @entity981 (BFM) 95 protocol. Plasma @entity1499 ( @entity1500 ) levels were determined at 24 and 48 hr after the infusion of high-dose (5 g/m(2)/24 hr) @entity1500 (MCA phase). RESULTS: The mean (SD) beta-glucuronidase activity prior to the onset of chemotherapy was 19.9 (5.6) nmoles/ @entity11108 /ml/hr. No significant changes in activity were noted during the phases of the protocol except of the MCA3. The activity was 24.4 (6.8) on MCA2, 28.4 (9.3) on MCA3, and 24.1 (9.5) on MCA4. The beta-glucuronidase activity was positively correlated with the plasma @entity1500 levels at both 24 hr (r = 0.483, P = 0.006) and 48 hr (r = 0.676, P < 0.0001). No progressive changes were noted during the different phases of the protocol. The greatest beta-glucuronidase activity was measured in two @entity1 with @entity2359 . CONCLUSIONS: The beta-glucuronidase activity is increased in the CSF of leukemic @entity1 receiving high-dose @entity1500 and particularly in @entity2359 . It is positively correlated with plasma @entity1500 levels. No cumulative effect of the chemotherapy was observed. The increased beta-glucuronidase activity is most likely due to enzyme leakage through the cell membranes caused mainly by a toxic effect of @entity1500 on the cells of the central nervous system (CNS).
