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Clinical studies on plasma cyclic nucleotide levels in acute leukemia



Clinical studies on plasma cyclic nucleotide levels in acute leukemia



Okayama Igakkai Zasshi 106(5-6): 549-560



Plasma levels of cyclic nucleotides were measured in 71 patients with acute leukemia (50 patients with acute nonlymphocytic leukemia (ANLL), five patients with hypoplastic leukemia, and 16 patients with acute lymphocytic leukemia (ALL)), five patients with myelodysplastic syndrome (MDS), and 47 healthy volunteers. The cyclic GMP (c-GMP) level, cyclic AMP (c-AMP) level, and c-AMP/c-GMP ratio in healthy volunteers were 15.74 +- 5.10 pmol/ml, 3.20 +- 1.15 pmol/ml and 5.39 +- 2.18, respectively. In the patients with untreated acute leukemia other than hypoplastic leukemia, c-GMP levels were significantly elevated (ANLL: 11.31 +- 13.61 pmol/ml; ALL: 10.66 +- 7.23 pmol/ml) and c-AMP/c-GMP ratios were significantly reduced (ANLL: 2.01 +- 1.03 ALL: 1.66-1.03). These values normalized at remission, then increased or decreased again with recurrence of the disease. Although patients with MDS showed normal c-GMP levels or c-AMP/c-GMP ratios, these values were increased or decreased when progression to acute leukemia occurred. There was correlation between c-GMP levels and peripheral leukocyte counts (r = 0.429, p lt 0.05), plasma c-GMP levels and peripheral leukemic cell counts (r = 0.412, p lt 0.05), c-AMP/c-GMP ratios and peripheral leukocyte counts (r = -0.577, p lt 0.05), c-AMP/c-GMP ratios and peripheral leukemic cell counts (r= -0.512, p lt 0.05), and c-AMP/c-GMP ratios and maximum counts of colonies derived from leukemic blast progenitors (r = 0.996, p lt 0.01). Since plasma levels of cyclic nucleotides reflect the leukemic cell proliferation, measurement of these nucleotides was considered useful for monitoring leukemic cell volume.

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