Neopteryna jako wskaźnik stanu zapalnego i rozrostu nowotworowego w ostrych białaczkach

Abstract

Introduction. Neopterin (NPT) is a sensitive marker for cellular immune responses. It is a pteridine group compound as a dye substance in insects, lower vertebrata and mammals. Neopterin is released from human monocytes, macrophages and dendritic cells upon stimulation by interferon gamma produced by T-lymphocytes. High neopterin concentrations in serum and urine were shown to be a reliable indicator for the severity of bacterial, viral infections including autoimmune diseases, allograft rejections and various malignant disorders. Aim. The aim of the study was the concentration of the neopterin in acute leukemias may be an endogenous marker of unfavorable processes in acute leukemia for which the growth of the tumor, the coexistence of inflammation. Material and methods. The studies involved 80 patients suffering from acute leukemias including 53 patients with acute myeloid leukemia, 21 patients with acute lymphoblastic leukemia and 6 patients with mixed phenotype acute leukemia. The patients with acute leukemia was analyzed as a group with inflammatory condition and a group without inflammatory condition. The quantitative assessment of serum neopterin level was performed by means of immunoenzymatic test ELISA. Results. Patients with all types of leukemia showed elevated serum neopterin levels in comparison to the control group and significantly elevated neopterin levels in patients with coexisting inflammation compared to the values of these parameters in patients without inflammation. The neopterin concentration was highest in the group of patients diagnosed with acute M4 and M5 leukemia, both without inflammation (32.8 ± 13.6 nmol/l) and with co-existing inflammation (116.57 ± 97.0 nmol/l) (p = 0.00024). Conclusions. Neopterin as a marker of malignant hyperplasia may be used only in cases where inflammation does not occur.