The prognostic value of acute phase reactants in patients with neuroblastoma.

As part of a more extensive study of the immune response in children with neuroblastoma, serum immunoglobulin and alpha-glycoprotein levels were measured in 58 patients. Twenty-nine children were studied at diagnosis, 18 at some time during the first 2 years of treatment, and 11 who were apparently cured after treatment had been completed. No correlation was found between the levels of IgG, IgA, and IgM and the clinical status of the patient. The acute phase reactants (alpha-1-antitrypsin, haptoglobin, C3 component of complement and orosomucoid) varied with the disease status. Twenty-seven of the 29 patients had elevated levels at the time of diagnosis. Alpha-1-antitrypsin and haptoglobin were the two proteins that most accurately reflection the clinical status; C3 component of complement was not infrequently normal when the disease was active; and orosomucoid was sometimes raised in patients apparently in remission. Serial measurement of alpha-1-antitrypsin and haptoglobin could provide a useful means of detecting early relapse in patients responding to treatment.