Neopterin; a marker of activation of cell mediated immunity in acute and chronic leukemias

In the current study, serum neopterin was tested in 20 patients with acute and chronic leukemia before the initiation of therapy and compared to 10 heatly age, sex matched volunteers. Serum neopterin was significantly higher among patients with leukemias when compared to controls [P <0.01] with a mean serum neopterin of 8.64 +/- 6.38 ng/ml vs 2.68 +/- 1.73 ng/ml. The highest levels of neopterin were observed in patients with CML who showed a very highly significant increase in neopterin levels [P <0.001], the highest level of 27 ng/ml being observed in a patients in an accelerated phase. In contrast, patients with CLL did not show elevated neopterin levels when compared to controls [P >0.05]. In patients with acute leukemias, on the other hand, levels were significantly elevated [P <0.01]. Raised neopterin is definitely not specific to a given diseases entity, but is an indicator of immunologic stimulation and may serve as prognostic marker in patients with hemotologic malignancies especially in chronic leukemias. Its value for the early detection of accelerated phase in CML and its staging values for CLL remains to be confirmed