Serum transcobalamin II in childhood histiocytosis syndromes.

It has been shown in a previous report that an extreme high serum TCII level was found in patients with malignant histiocytosis and patients with proliferative histiocytosis. The objective of the present study was to Langerhans cells histiocytosis and 6 patients with malignant histiocytosis. Serum TCII levels in both groups of patients were not significantly different from those of normal subjects. Furthermore, serum vitamin B12 and other transcobalamins levels were also within the normal limits. These findings do not support the results reported earlier in adult patients either with malignant histiocytosis or with proliferative histiocytosis. The suggestion that determination of TCII may be a useful indicator of activity and size of the macrophage/histiocyte system is therefore not proved in childhood histiocytosis syndromes.

Folates and vitamin B12 status in patients with multiple myeloma.

Serum and red cell folate, serum Vitamin B12 and Vitamin B12 binding proteins were multiple myeloma. Half of these patients were anaemic with a predominant macrocytic type. Altogether 17 and 33 percent had low serum and red cell folate levels, respectively. Low serum Vitamin B12 level was found in one third of these patients. Both TCI and TCIII increased while TCII decreased, while was different from the previous report of extremely elevated TCII in some patients with multiple myeloma. There was a direct relationship between serum Vitamin B12 and saturation of TCI. These finding indicated that folic acid and Vitamin B12 deficiency were relatively common in patients with multiple myeloma. The possible mechanisms of these vitamins deficiency were discussed in this paper.

Serum cholinesterase and erythrocyte acetylcholinesterase activity in patients with neuroblastoma.

Serum cholinesterase (ChE), red cell acetylcholinesterase (AChE), were determined in 18 neuroblastoma patients ages ranged from 8 months to 4 years. Sixteen patients (89%) were anemic and 15 patients (83%) showed bone marrow invasion and/or liver involvement. Both mean values of serum ChE and red cell AChE activities were significantly lower than those of 80 normal subjects. There was no relationship between red cell AChE and Hb, Ht or white blood cell count. The cause and mechanism of reduced serum ChE and red cell AChE activities in patients with neuroblastoma were possibly due to the invasion of the liver and bone marrow by the tumor cells. Although neuroblastoma cells can synthesize AChE which is inversely regulated by the rate of cell division, determination of serum ChE and red cell AChE could not serve to distinguish neuroblastoma from the other types of human tumour cells.

Superoxide dismutase, catalase and acetylcholinesterase in the red cells of patients with multiple myeloma.

Serum cholinesterase (ChE), red cell acetylcholinesterase (AChE), superoxide dismutase (SOD) and catalase were determined in 12 patients with multiple myeloma. Serum ChE was significantly depressed and bore a derect relationship with serum albumin concentration or Hb level. Red cell AChE was significantly elevated and showed a tendency of a reverse relationship with Hb. There was increased serum uric acid and 25% of the patients had serum uric acid over 9 mg/dl. Both SOD and catalase activities were found to be within normal limits, and showed no relationship with serum uric acid. These finding indicated that hyperuricemia occurs quite commonly in multiple myeloma patients with increased extracellular oxidants released from the degradation of purines to uric acid. However, these toxic oxidants could not overcome the antioxidant capacity of the red cells as indicated by a finding of normal SOD and catalase activities.

Serum vitamin B12 and vitamin B12 binding proteins in patients with polycythemia vera.

Serum vitamin B12 and vitamin B12 binding proteins (Transcobalamin, TC) were determined in 11 patients with polycythemia vera (PV) and each patient with PV asso ciated with multiple myloma (PV/MM) and acute myelomonocytic leukemia (PV/AMML). The study was also performed on 60 normal subjects for comparison Serum vitamin B12 level and total vitamin B12 binding capacity (TBBC) were found to be significantly increased while serum unsaturated vitamin B12 binding capacity (UBBC) was slightly but not significantly higher than that of normal subjects. Both TCI and TCIII in creased 2 and 4 fold, respectively, while TCII decreased to haft the value of the normal level. This resulted in the alteration of the ratio of TCI/TCIII from 1.34 in normal subjects to 0.75 in these patients. This finding is quite specific for PV, because another 2 patients with PV associated with MM and AMML also showed a similar TCI/TCIII ratio. Although increased serum vitamin B12 UBBC, TCI and TCIII are also found in some patients with myeloproliferative disorders and leucocytosis, in no situation is it characterized by a predominantly increased TCIII with a reverse ration of TCIII/TCI as in PV. Therefore, the assay of serum vitamin B12 UBBC and TC should be a useful tool in the confirmed diagnosis of PV.

Hyperuricaemia and antioxidant enzymes in red cells of patients with malignacy of haematological origin.

Serum uric acid, red cell SOD and catalase activities were determined in 117 patients acute lymphoblastic leukaemia, chronic myelocytic leukaemia, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, polycythemia vera and multiple myeloma in comparison to 40 healthy normal subjects. About 6-40 percent of these patients had serum uric acid level over 7 mg/dl. Altogether, 14 patients had hyperuricaemia, therefore they were grouped together. There was a reverse relationship between serum uric acid level and SOD activity in these patients. The hyperuricaemia is a result of increased proliferation and destruction of tumour cells which stimulates the generation of superoxide radicals. Therefore, red cell SOD will be decreased in patients with hyperuricaemia. In order to compensate for an elevated oxidant stress, SOD will therefore increase. These findings could explain the variable results of red cell SOD reported earlier in patients with malignancy of haematological origin. There was no relationship between serum uric acid and red cell catalase activity in these patients.

Serum and red cell folates in patients with leukaemia and lymphomas.

It has been suggested that leukaemia and lymphomas may cause folic acid depletion. The supporting evidence were obtained from urinary excretion of folic acid, rate of clearance of injected folic acid from the plasma and serum folic acid assays. However, no data red cell folate levels has been reported, the present study was there fore undertaken. Serum and red cell folate levels were determined in 144 patients with acute lymphocytic leukaemia, acute myeloblastic leukaemia, chronic myelocytic leukaemia, Hodgkin’s disease and non-Hodgkin’s lymphoma. The mean serum and red cell folate values in these patients were significantly lower than those of normal subjects. About 21.5% and 28.5% of these patients had serum folate levels lower than 3 ng/ml and red cell folate levels lower than 100 ng/ml, respectively. The elevated MCV and MCH values were also found in 42% and 30% of the patient’s groups. These findings indicated that some patients with leukaemia and lymphomas had macrocytiosis which was highly due to folic acid deficiency. The deficiency may be caused by various factors such as increased requirement due to an elevated production of leukaemic cells with higher folic acid content than normal leucocytes, poor dietary folic acid intake due to loss of appetite and intestinal malabsorption of lolic acid.

Erythrocyte superoxide dismutase and catalase activities and serum uric acid in patients with malignant lymphoma.

Many previous studies on superoxide dismutase (SOD) and catalase activities in red cells of patients with malignant lymphoma showed results. One possible factor may be the different oxidant stress in these patients. The objective of the present study was determine SOD and catalase activities in red cells of patients with untreated malignant lymphoma who had normal serum uric acid level. The studies were performed on 19 patients with Hodgkin's disease and 34 with non-Hodgkin's lymphoma (NHL) in comparison to 40 healthy normal subjects. The mean values of erythrocyte SOD activity in these patients were not significantly different from that of normal subjects. Serum uric acid levels were also within the normal ranges and only 4 out of 53 patients had serum uric acid over 7 mg/dl. There was no relationship between serum uric acid level would have red cell SOD within the normal limits. As hyperuricaemia may occur as a result of increased purine turnover from the increased destruction of tumor cells by therapy. The overproduction of uric acid would stimulate the generation of superoxide radicals. In such cases, red cell SOD would therefore be decreased during the hyperuicaemia. These findings may therefore explain why some previous authors found either increased or decreased SOD activity in red cell of patients with malignant lymphoma. No significant differentce of erythrocyte catalase activity between the groups of patients and the normal group was demonstrated in the present study.

Superoxide dismutase and catalase activities in red cells of patients with malignancy of haematological origin.

Superoxide dismutase (SOD) and catalase activities were determined in 55 patients with acute lymphoblastic leukaemia (ALL), acute megaloblastic leukaemia (AML) and non-Hodgkin lymphoma (NHL) in comparison to 40 healthy normal subjects. Their ages ranged from 2 to 10 years. The mean value of erythrocyte activity in these patients was not significantly different from up for 6 months also showed the tendency of decreased values to be lower than the lower limits of normal values. There was no relationship between SOD activity and Hb, Hct, red cell count in these patients. These findings did not confirm the previous report that erythrocyte SOD activity was significantly higher in patients with CLL, AML, Hodgkin’s disease and lymphosarcoma. No significant difference of erythrocyte catalase activity between the groups of patients and the normal group was demonstrated in the present study.

Cholinesterase activity in serum and red cells of patients with retinoblastoma.

Serum cholinesterase (ChE) and erythrocyte acetylcholineaterase (AChE) activities were determined in 25 patients with retinoblastoma as well as in 80 normal subjects. There was no significant difference between the mean values of serum ChE in the group of patients and the normal group. These patients had a significantly lower mean value of red cell AChE activity than that of the normal subjects (P<0.01). Eleven out of 25 (44%) patients had red cell AChE activity lower than the normal limits. There was no relationship between erythrocyte AChE activities and Hb, Ht, red cell and white cell counts. Only 2 (8%) and 5 (20%) patients showed bone marrow and liver involvement, respectively, while 9 (36%) patients were anaemic. The cause and mechanism of reduced erythrocyte AChE activity in patients with retinoblastoma was not exactly known. One possibility was that the chromosome defect which predisposed to retinoblastoma may be the cause of intrinsic cellular defect of AChE synthesis.