S100B Protein In Serum And Cerebrospinal Fluid Monitoring Analysis Of Children With Acute Lymphoblastic Leukemia Treated With High_dose Methotrexate

Objective As acidic calcium-binding proteins,S100B proteins are considered biomarkers of glial cell and brain-specific proteins which specially exist in the cerebral glia cells,astrocytes.oligodendrocytes,also have the obvious distribution in most of sensory neurons and cerebellum nuclei.They non-specifically participate in the pathogenesis of ischemia by means of calcium overload,inflammation and so on. CNS is gradually being accepted by HD-MTX in acute lymphoblastic leukemia (ALL).We investigate possible side effects on the central nervous system from hign-dose methotrexate therapy(HD-MTX) given during treatment for ALL in childhood.To study the trauma for central nervous system(CNS) from HD-MTX and intrathecal injection(IT) with methotrexate arabinosylcytosin and dexamethasone through detecting S100B protein content in serum and cerebrospinal fluid(CSF). To monitor the serum MTX concentrations of 24h,44h,68h and CSF MTX concentration of 0.5h.To investigate the effects of therapeutic drug monitoring of high dose methotrexate on childhood central nervous system leukemia prophylaxis. To compare the relativity of human serum concentrations of MTX and S100B protein.Methods 12 cases acute lymphoblastic leukemia(ALL).patients were studied from November,2007 to December,2008.The S100B in serum and CSF was detected with ELISA.The concentrations of MTX in serum and CSF were measured by fluorescence polarization immuno_assay(FPIA).Result S100B protein was(0.958±0.160ng/ml) in 24h afer treatment and there was significantly than ALL group(0.688±0.130ng/ml) before treatment,and(0.748±0.153ng/ml) in 44h and(0.689±0.130ng/ml) in 68h after treatment.S100B protein was(0.748±0.153ng/ml) in 44h and(0.689±0.130ng/ml) in 68h after treatment and there was no significantly than ALL group(0.688±0.130ng/ml) before treatment. There was no significantly change of S100B protein(4.886±0.589ng/ml) before IT,and(5.163±0.687ng/ml) at 30 minutes,and(5.269±0.644ng/ml) at day 10, and(5.128±0.619 ng/ml) at day 20 after IT.One sixth of MTX with total dose 3g/m~2 was administered within 30 min through intrathecal injection while rest was intravenous drip within 23.5 hours,36 hours later CF rescue started.Serum MTX concentrations of 24,44,68h were respectively 23.688±9.607umol/l,0.338±0.247umol/l,0.045±0.033umol/l.CSF MTX concentration of 0.5h was 0.192±0.171umol/l.The regression equation of the results determined by S100B protein and serum MTX concentrations within 24 hours(?)=0.602x+0.013(r=0.786).Conclusion S100B protein was a useful marker in diagnosis of harm to CNS in serum.S100B protein was safe and effective because of non_harm to CNS in CSF in the near future.Therapeutic drug monitoring provided useful data for HD-MTX+CF treatment and confirmed the reliability and safety of the scheme.There is good the relativity of human serum concentrations of MTX and S100B protein.