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Background: Diagnosis of leukemiamay be complicated due to the polyvalent symptoms in childhood. In this study, our goal was to determine the potential for early diagnosis of leukemia or relapse using the proliferation marker thymidine kinase 1 (TK1). Methods: In the group of 58 children diagnosed with leukemia, we monitored levels of TK1 at the time of diagnosis, during and after therapy using radioenzymatic assay. Control group included 109 children with benign diseases displaying clinical symptoms similar to leukemia. Results: We demonstrated the difference in the levels of TK1 at the diagnosis of leukemia compared to patients with other benign diseases (p<0.0001). We also observed that after completing treatment of leukemia, each patient achieved certain basal level of TK1, and the future increase above this basal level (after exclusion of viral infection and hepatopathy) was significant for prediction of a relapse, which often followed 3 to 9 months after the elevation of TK1 (p<0.03). Conclusions: Our study shows that TK1 is a suitable proliferation marker for diagnostics and follow up in pediatric patients with leukemia. [ABSTRACT FROM AUTHOR]