Evaluation of polyamine levels in cerebrospinal fluid of children with brain tumors

Abstract

Cerebrospinal fluid (CSF) polyamine levels were analyzed retrospectively in 21 pediatric patients with different types of intracranial malignant tumors to determine the benefit of following these markers during the clinical management of brain tumors. The tumors included 16 medulloblastomas and 1 each of germinoma, ependymoma, primitive neuroectodermal tumor, astrocytoma, and malignant teratoma. The clinical course of each patient was followed by neurologic examination, cranial computed tomography, CSF cell count, and cytology after cytocentrifugation. The correlation of CSF putrescine and spermidine levels with the clinical course of the brain tumors was analyzed. The following results were obtained: (1) A significant increase in CSF putrescine levels was observed in children with medulloblastoma when there was recurrent or metastatic disease in the sites close to the CSF pathway compared with the children whose disease status was stable after successful treatment (P less than 0.005). (2) The increase of CSF putrescine levels was the earliest predictor of recurrence or metastasis near the CSF pathway. (3) In tumors other than medulloblastoma, the levels of polyamines were not predictive of disease activity with the possible exception of germinoma. (4) Spermidine levels in the CSF were of limited clinical importance for patients with brain tumors. CSF putrescine levels may be the earliest and most sensitive quantitative marker of the progression of medulloblastoma, and their evaluation should be included in the diagnostic work-up and follow-up examination of children with medulloblastoma.

Measurements of CSF biochemical tumor markers in patients with meningeal carcinomatosis and brain tumors

“…The increase in beta-glucuronidase is specific to meningeal carcinomatosis [3][4][5]. Polyamines are useful primarily as an index of the recurrence and progression of medulloblastoma [6][7][8][9] and are also increased together with betaglucuronidase in meningeal carcinomatosis and malignant tumors [10,11], indicating the degree of tumor growth [6,11]. In metastatic brain tumors, plasma CEA is sometimes increased, but CEA in CSF is rarely increased.…”

Measurement of 5′‐methylthioadenosine in patients with neoplasms

“…Subsequently, several investigations of polyamines in neoplastic patients have been completed (Horn et al, 1982;Tabor and Tabor, 1984). Determination of the concentration of polyamines not only in urine (Fujita et al, 1976) but also in serum (Nishioka and Romsdahl, 1974), erythrocytes (Chatel et al, 1987) and other tissues (Romano et al, 1985;Moulinoux et al, 1985;Takaue et al, 1986;Phillips et dl., 1986) may be useful for the diagnosis of neoplasms and as indicators of the effect of chemotherapy (Durie et al, 1977;Bakowski et al, 1981).…”