The cerebrospinal fluid in acute leukaemia of childhood: studies with the Cytocentrifuge.

The Cytocentrifuge enables a satisfactory cytological preparation to be made when the cells in the cerebrospinal fluid are normal in number or only slightly increased. A technique has been developed and the results of its use are described in 114 consecutive samples from 50 children with acute leukaemia, with and without involvement of the central nervous system. Analysis of the results showed that 30% of the samples with a normal cell count contained leukaemic cells when examined by Cytocentrifuge. Only 74% of the samples with raised counts were found to contain leukaemic cells. Diagnosis of leukaemic meningitis based on changes in the cell count alone in cerebrospinal fluid is clearly unreliable, and the Cytocentrifuge enables a more precise assessment of the cerebrospinal fluid to be made. It also appears that changes in the levels of protein and glucose in the cerebrospinal fluid of leukaemic patients are not directly related to the presence of leukaemic cells but are the results of changes in the cell count from whatever cause. There appears to be no value in measuring protein and glucose levels when monitoring the cerebrospinal fluid in acute leukaemia for evidence of early involvement of the central nervous system.