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Polyamines have been implicated to play a role in cell prolifer-In vivo studies have shown that RBC polyamine levels can be ation and in cancer development. Ninety percent of the circulatused as an index of neoplastic 10 and normal cell prolifering spermidine (Spd) and spermine (Spm) are transported by ation. 11 We have shown that RBC Spd levels can be used as red blood cells (RBC). RBC Spd and Spm levels were prospecan index of bone marrow cell proliferation. 12 Based on the tively determined in 63 unselected children with common acute hypothesis that the RBC polyamine level could be a risk indilymphoblastic leukemia. The Spm and Spd levels were not correlated with white blood cell (WBC) count. On the basis of the cator in ALL, the following investigations were carried out: polyamine levels it was possible to discriminate four groups RBC Spd and Spm levels were prospectively determined in 63 with P Ͻ 10 −3 . In C1, C2, C3 and C4 group the Spm level was unselected children with common ALL. In this group of respectively 90 (39-597), 3.75 (1-7.45), 9.95 (2.9-12.6) and patients RBC Spm levels did not correlate with leukemic 17(6.3-33.8). The probability of relapse-free survival (RFS) of cell mass but allowed the children to be segregated into two the 58 children who entered complete remission was 55% ؎ 9.populations with a significantly different outcome.For the groups C1 (n ‫؍‬ 6), C2 (n ‫؍‬ 16), C3 (n ‫؍‬ 21) and C4 (n ‫؍‬ 15) groups, the RFS was 25% ؎ 20, 73% ؎ 12, 73% ؎ 13 and 32% ؎ 13 respectively. For children with Spm levels Ͻ13/у13 nmol/8 ؋ 10 9 RBC, event-free survival (EFS) was 54% ؎ 11/33% ؎ 10 and RFS was 64% ؎ 12/38% ؎ 11 respect- Materials and methodsively (P Ͻ 0.03, P Ͻ 0.005). Our clinical study shows clearly that an RBC spermine level could be used as parameter of progPatients nosis at the time of diagnosis, particularly for patients with intermediary WBC count. Keywords: polyamine; acute leukemia; children; spermine, spermiSixty-three children were hospitalized for newly diagnosed dine; multiple correspondence analysis common ALL in the Department of Pediatric Hematology at the University Hospital in Rennes. All patients were included in French trials ongoing at the moment of the diagnosis Introduction including (1) induction phase with vincristin, prednisone, anthracycline, l-asparaginase; (2) consolidation phase with Common acute lymphoblastic leukemias (ALL) in children are high dose methotrexate; (3) CNS-directed therapy with intrausually classified according to their clinical and biological thecal therapy and cerebral irradiation; and (4) continuation status at the time of diagnosis. For 20 years, age, liver and phase with daily administration of 6-mercaptopurine and spleen size, and white blood cell (WBC) count have been the weekly administration of methotrexate. 13 major parameters in use to classify standard or high risk leukemias; 1 these factors were also used as the basis for the choice of treatment. As treatment progressively improved survival Diagnosis rates reached 75% of EFS probabi...

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