Erythrocyte Metabolism in Protein-Energy Malnutrition Anaemia. I. Glucose Metabolism and Reduction of the Activated Oxygen

Abstract

Children's hospital and Kantonsspital, 9000 S t . Gallen Malignant lymphoma with leukemic conversion is characterized by a rapid tumor progression and poor prognosis. In acute lymphocytic leukemia however the outlook has impmved markedly in the l a s t years. Uany children exhibit complete remission for a long time and cure is even possible. In order t o d i f f e r e n t i a t e between t h i s two diseases and t o t r e a t patients separately, we analyzed the c l i n i c a l data of 8 children, aged 2 t o 12 years, who entered the children's hospital of St. Gallen i n the l a s t year. Based on c l i n i c a l findings and with the aid of a biopsy (EM), cytochemical and immunological studies, we interpreted Ir patients a s stage IV non Hodgkin lymphoma with leukemic transformation and Ir patients a s acute lymphocytic leukemia. Of the 1( patients with malignant lymphoma, diffuse lymphoblastic, t h e new e n t i t y "convoluted type" was seen i n 2 patients. One was a 3 months old baby with probably congenital m a l i e a n t lymphoma. The distinction between acute lymphocytic leukemia and non Hodgkin lymphoma with bone mamw involvement is made on c l i n i c a l c r i t e r i a s . These c r i t e r i a s a r e discussed. In an attempt t o reduce CNS involvezect i n high r i s k childhood acute lymphocytic leukemia, 500 mg/m2 methotrsate (MTX) a s a 4-hour infusion was added t o the skull irradiation of 2400 raffi and slxth intrathecal MTX injection, followed by Leucovorin resccs a t 24 hours. MTX levels were measured by an 1~~5 NTX competetive enzfle binding technique (New England Enzyre Center, Boston). I n 8 children r i t h high r i s k acute lymphocytic leukelia very high CSF levels, 2.5~10-4 and 1.6~10-6 at 4 and 23 hours respective1 were found, a s compared rrl'.h pilrallel serum levels of 9.9~10-4 and 7.3~10-?. I n contrast, a 5 gm/mZ I.TX 6-hour infusion without intrathecal MTX failed t o achieve "tharapeuilc" levels of 10-6 a t 24 hours. Higher SF levels were observed i n CNS md marrow relapse 1.76~10-3 and 3 . 3~1 0 -~ a t 4 and 29 hours respectively. I n two cases toxicity w a s ansoci a t n d with transient Lnereased serum crsa:Lnine and correlated with toxic MTX levels. I t is concluded that t h i s additional therapy resultod i n sustained therapeutic C; F MTX levels by preventing MTX eflux from CSF, thus giving more effective brain penetration and preventing CNS leukemia. VITAMIN E AND ERYTROCYTE GLUTATKIONE-PEROXIDASE I N NeVlBORNINFANTS ' YITH HYPERaILIRWINEXIA. k~e t t o r i . G . F a l c i a n i , L . C i c c o l i , M.De Donno. C.De Simone, R. B r a c c i . I n s t . C l i n i c a P e d i a t r i c a a n d I n s t . P a t o l o g i a G e n e r a l e --U n i v e r s i t y o f S i e n a , I t a l y .Plasma v i t a m i n E a n d ery?rocyte C-6-PD, GR. FK a n d GSH-Px a c t i -ERYTHROCYTE ttETABOLI PI 114 PROTEIN-ENERGY F' ALHUTRITIOA AHAEIiIA. I . GLUCOSE FiETABOLISM A I D REDUCTION OF THE ACTIVATE0 OXYGEN. P. Fondu, J . Nsve, C. Heyder-Bruckner. F. V e r t o n g e n and I.M. Eandelbaum. Cem...