Combined assay of adenosine deaminase, purine nucleoside phosphorylase, and lactate dehydrogenase in the early clinical evaluation of B‐chronic lymphocytic leukemia

Abstract

The levels of adenosine deaminase (ADA), purine nucleoside phosphorylase (PNP), lactic dehydrogenase (LDH), and LDH isoenzyme patterns (LD1 to LD5) have been measured in lymphocyte extract from 28 patients with B-chronic lymphocytic leukemia (B-CLL). The activities of ADA, PNP, and LDH have been correlated with two morphological groups of B-CLL classified according to the percentage of large, nongranular, atypical lymphocytes (AL) in peripheral blood: "typical" B-CLL (less than 10% of AL, 21 cases) and "atypical" B-CLL (10-25% of AL, seven cases). Patients with atypical B-CLL had significantly (P less than 0.001) higher activities of ADA (0.46 +/- 0.17 U/10(9) cells), PNP (1.74 +/- 1.0 U/10(9) cells), and LDH (48.3 +/- 9.7 U/10(9) cells) than patients with typical B-CLL (ADA, 0.29 +/- 0.1 U/10(9) cells; PNP, 0.58 +/- 0.23 U/10(9) cells; and LDH, 29 +/- 10 U/10(9) cells). In addition, the "treatment-free period" was also significantly (P less than 0.025) shorter in the group of atypical B-CLL compared with the typical B-CLL group. No clear-cut statistical differences in lymphocyte surface markers or in several other prognostic factors between the two subgroups of B-CLL were found. The present study supports the idea that in B-CLL the simultaneous determination of ADA, PNP, and LDH might be helpful in better understanding the pathophysiology, prognosis, and natural history of the disease.

Good prognosis cytogenetics in B-cell chronic lymphocytic leukemia is associated in vitro with low susceptibility to apoptosis and enhanced immunogenicity

“…On the other hand, it is known that a high level of serum LDH, which is a measure of tumor burden and turnover, is associated with rapid disease progression and worse clinical prognosis in B-CLL. 2,36,37 In our studies, spontaneous in vitro apoptosis was higher in samples with poor prognosis cytogenetics. In addition, spontaneous B-CLL cell cytogenetic status influences survival and immunogenicity B Jahrsdörfer et al apoptosis in vitro correlated with higher clinical levels of serum LDH, suggesting that the in vitro observation of higher cell death is not simply artifact, but is likely occurring in vivo as well.…”

Surface expression of adenosine deaminase in mitogen-stimulated lymphocytes

“…For each of these stages a precise level of ADA and 5'-nucleotidase, among other enzymes, occurs [25]. It is clear, not only for T cell-derived leukaemias but for most types of haematological malignancies, that the level of purine degradative enzymes is useful for the diagnosis and/or prognosis of the disease [1,[26][27][28]. Finally, an interesting possibility that should be further explored is that purine metabolizing enzymes present on the surface of the cells may be important accessory molecules for cell triggering.…”

Relationship between Lymphocyte Size and Enzyme Activities in Two Morphological Variants of B-Chronic Lymphocytic Leukaemia

“…According to the percentage of AL as defined elsewhere [13], the patients were divided into two main groups: typical B-CLL (< 10% AL; 28 cases) and atypical B-CLL (10-25% AL; 11 cases). These percent of AL were shown in a previous study of 28 cases to define two groups of patients with different clinical and laboratory features [13]. No patients with serum-M component were included, and for comparison of enzyme studies a control group of 10 healthy volunteers was used.…”

“…To this end, it has been suggested that differ ences in cell size [2,[4][5][6][7][8] and enzyme activities [9][10][11][12] of the circulating B-CLL lymphocytes may relate to the different clinical behaviour of the disease. In a previous report [13], an attempt was made to evaluate the activity of lymphocyte adenosine deaminase (ADA), purine nucleoside phosphorylase (PNP) and lactate dehydrogenase (LDH) in two morphological subgroups of B-CLL classified according to the per centage of circulating large non-granular atypical lymphocytes (AL). The results obtained demonstrated that the determination of these enzyme activities in addition to cell morphology might be useful for moni toring early clinical changes in B-CLL.…”

“…Our aim was two-fold: (1) to assess the influence that the cell volume may have in the different levels of ADA, PNP and LDH previ ously documented in the two morphological groups of B-CLL [13], and (2) to study the levels of the main glycolytic enzyme activities which may contribute to glycogen accumulation frequently observed in B-CLL lymphocytes [14], …”