The prognostic value of acute phase reactants in patients with neuroblastoma

Developments in the biology of neuroblastoma: implications for diagnosis and treatment

There has been little improvement in the prognosis for neuroblastoma in childhood over recent years. The authors review recent investigations into the biology of the tumour and discuss their implications for diagnosis and therapy. Immunological studies suggest a heterogeneity in cell-surface antigens on different human neuroblastoma lines/fresh tumours. The reagents being developed against these antigens will play a rôle in the diagnosis of metastatic spread, and may be useful in autologous bone-marrow transplantation programmes. The occasional in vivo differentiation of the tumour is reviewed, with particular reference to in vitro studies on the differentiation of human and murine neuroblastoma cell-lines. This work may have implications for therapy if ways can be found to cause in vivo differentiation of the tumour into a benign ganglioneuroma.

Circulating immune complexes in sera of children with neuroblastoma: correlation with stage of disease

The presence of circulating immune complexes (ICS) in freshly drawn sera of 67 children with neuroblastoma was studied by the Raji cell radioimmunoassay of Theofilopoulos et al. (J. Clin. Invest. 57: 169--182), with particular emphasis on the correlation of levels of ICS with stage of disease and changes attributable to treatment. There was a close correlation between amount of complexes and stage of disease and treatment. Levels of ICS increased as the stage of the disease advanced, and were significantly higher (P less than 0.005) in stage IV than in all other stages combined. When patients with stage IV disease were subdivided into "before," "during," and "after" treatment groups, there was a significant decrease in ICS levels as treatment progressed. Studies of complement and complement components did not give such a clear relationship. A significant decrease of hemolytic C1 values was found in patients with "active disease" compared to normal age-matched controls. Some high C3 levels, determined immunochemically, were associated with low hemolytic levels of C3, which were attributed to C3 cleavage detected by immunoelectrophoresis. Based on our survival data, ICS, which were significantly different in 20 patients now decreased when compared to those of other patients, are very valuable in the prognosis of neuroblastoma.