Serum interleukin 2 receptor levels in childhood acute lymphoblastic leukemia

The clinical significance of interleukin 2 receptor (IL2R) concentrations in serum was determined for 344 children with newly diagnosed acute lymphoblastic leukemia (ALL). Serum levels of IL2R in patients (267 to 80,000 U/mL, median 2,007 U/mL) were significantly higher than normal control values (170 to 738 U/mL, median 347 U/mL) (P less than .0001). Measurements in cases of T cell ALL were lower than in the non-T, non-B cases (P = .02). Among the 264 patients with non-T, non-B ALL, but not in those with T cell disease, higher serum IL2R levels (greater than 2,000 U/mL) were associated with a poorer treatment outcome (P = .04). In a multivariate analysis, serum IL2R level contributed independent prognostic information beyond that conveyed by leukocyte count, race, and age (P = .04). One explanation for these results is that soluble IL2R competes with normal lymphocyte- integrated IL2R for the ligand and thus could suppress host antitumor immunity.     

Central nervous system tumors in children: detection by magnetic resonance imaging

Fifty-one pediatric patients who were suspected of having central nervous system (CNS) tumors underwent magnetic resonance (MR) imaging using a 0.35 T Diasonics MT/S system. Pulse intervals (TR) ranged from 0.5 to 2.0 seconds with echo delays (TE) of 28 and 56 msec. The ability of MR and contrast-enhanced CT to detect focal lesions, determine lesion extent, and evaluate associated abnormalities was compared. In most patients in whom there was suspected spinal cord disease, comparison with myelography was made. Thirty-three intracranial lesions were detected with at least one imaging modality in 43 cranial examinations. MR was judged superior to CT in 14 of these cases and CT superior to MR in only one. Of eight spinal examinations, there were six that demonstrated abnormal findings. MR was superior to CT in all six cases and better than myelography in four of five cases where myelography was performed. Spin echo (SE) sequences with long pulse intervals were the most sensitive, but in some cases short pulse intervals permitted further characterization of the lesion. Patient motion was not a problem; sedation was routinely used in children younger than five years of age. MR imaging has rapidly become a valuable diagnostic modality in neuroradiology. The lack of ionizing radiation and the ability to evaluate the spinal cord noninvasively makes it particularly attractive in examination of children.