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KMID : 0351819980390020229
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Kyunpook University Medical Journal
1998 Volume.39 No. 2 p.229 ~ p.236
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Thymidine Kinase As Prognostic Factor in Acute Leukemia
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Jung Jin-Tae
Park Sung-Won
Baek Jin-Ho
Kim Dong-Hwan
Kwak Dong-Seok
Park So-Hyang
Sohn Sang-Kyun
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Abstract
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Background : Thymidine lanase catalyzes the phospholylation of deoxythyntidine to deoxythymidine tnonophosphate, an essential precursor of DNA thytnidine. Thyndine ldnase increases in connection with tissue regeneration, embryonal development, tumor growth and certain virus infection. Elevated thymidute lanase levels were observed in patients with different malignant diseases and several studies have shown the prognostic value of the serum level of thymidine kinase in Non-Hodgkin´s lymphoma, Hodgkin´s disease, acute non-lymphoblastic leukemia, small cull lung cancer, multiple myeloma, adenocarcinoma of the breast and prostatic adenocarcinoma.
Purpose : The aim of this study was to investigate how the leve:I of serum thymidine lanase correlated to the type of acute leukemia, the disease status of patients with leu)v~mia and the response to treatment.
Patients and method : In 33 patients(AML: 23, ALL: 6 anti other leukemia(tmixed, biphenotype or undifferentiated leukemia: 4) with acute leukemia, except who has actrte infection, serum levels of thytnidine Idrtase were monitored by [Weans of a radioenzyrrte assay(Prolifigen TK-12EA,, AB Sangtek Medical, Sweden) based on the transformation of a radioactive substrate in a sF~ecific radioactive product.
Results : In patients with acute leukemia, mean serum levels of thymidine lipase were 343.778.4 for AML,, 723.0 ~- 395.2 for ALL and 1565.8-*_-1162.9 for other actrte leukemia. A significant correlation was found between serum levels of thymidine lipase and age, peripheral WBC count, peripheral blast ratio, cellularity of bone marrow and serum LDH. Thymidine kinase were lower in M3 subtype of acute leukemia than non-M3 subtype of acute leukemia(99.0 i- 3~t.8 vs 474.2 104.9) and lower in complete remission state than disease state(93.954.0 vs 686.5204.7). But, there was no difference in serum levels of thytnidine kinase between the first occurred group ~tnd relapsed group of acute leukemia and also in pretreatment levels of thymidine kinase between complete remission group and refractory or relapsed group. There was a significant difference in survival time between serum levels of thymidine ldnase above 50 group and below 50 group.
Conclusion : The results indicate that serum levels of thymidine kinase reflect the disease status of acute leukemia and have a significant correlation with survival time. But, no significant correlation between serum levels of thymidine ldnase and therapeutic response is noted.
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KEYWORD
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hymidine kinase, Acute leukemia, Prognostic factor
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