Plasma dopa and catecholamines in the diagnosis and follow-up of children with neuroblastoma.

Plasma dopa and the catecholamines--dopamine, norepinephrine, and epinephrine--were assayed by a radioenzymatic method in 15 children with active neuroblastoma and in eight others without evidence of disease to assess the value of these determinations in the diagnosis and management of the tumor. Thirty-four children with solid tumors and hemopoietic malignancies served as our controls. Elevated plasma dopa levels were observed in 13 children with active neuroblastoma (87%); dopamine and norepinephrine were elevated in 1/4 of these patients. In the group of children with neuroblastoma without evidence of disease, dopa and catecholamine levels were within the range observed in the controls. Total urinary catecholamines, homovanillic acid (HVA) and/or vanilmandelic acid (MVA) were elevated in 11 of the 15 (73%) neuroblastoma patients with active disease. While serial plasma dopa determinations correlated with the course of the disease in practically all patients and thus were useful in their follow-up, the catecholamines were of limited value in assessing tumor status. Our results suggest that plasma dopa, assayed by a radioenzymatic method, may be more reliable than the traditional urinary catecholamine determinations in the diagnosis of neuroblastoma, and it appears useful in the management of this disease.