J Clin Pathol Qual Control.
1998 Dec;20(2):393-399.
Clinical Value of Plasma Adenosine Deaminase Activity in Acute Lymphoblastic Leukemia
- Affiliations
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- 1Department of Clinical Pathology, St. Mary's Hospital, Catholic University Medical College, Seoul, Korea.
- 2Department of Medicine, St. Mary's Hospital, Catholic University Medical College, Seoul, Korea.
- 3Department of Clinical Pathology, Capital Armed Forces General Hospital, Seoul, Korea.
Abstract
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BACKGROUND: Adenosine deaminase (ADA) activities in sera are increased in various diseases such as hematologic malignancies, tuberculosis, and liver diseases. To evaluate the clinical value of measuring ADA and its isoenzyme activities in plasmas with the automated assay in acute lymphoblastic leukemia, we compared ADA and its isoenzyme activities in normal control group with those in acute lymphoblastic leukemia group, and followed up those during chemotherapy in ALL group.
METHODS
We determined the range of ADA in 25 patients with acute lymphoblastic leukemia (ALL), and in 25 healthy adults without previous hematopoietic diseases as normal control group. We followed up ADA and its isoenzyme activities for two months per a week in 10 patients with ALL after chemotherapy until these levels were normalized. So there were no significant difference between ADA activities in sera and those in plasmas of random 25 cases, we used EDTA-treated plasmas for specimens which were convenient to get. The activities of ADA were determined by the kinetic method with Hitachi 747 autoanalyzer, and ADA isoenzyme was determined by adding treatment with EHNA, selective inhibitor to ADA1, to same method.
RESULTS
Mean of plasma ADA activities in normal control group was 14.28+/-3.26 IU/L and mean of them in ALL group was 54.39+/-31.37 IU/L. ADA, ADA(1), and ADA(2) activities in ALL group were higher than those in normal control group. On the patterns of ADA isoenzyme, ADA(2) was predominant (about 77% of total ADA) in normal control group, and ADA(1) was predominant (about 62% of total ADA) in ALL group. The follow up study in ALL revealed that ADA activities were normalized after chemotherapy within 6 weeks (mean 4.8 weeks) regardless of remission. ADA(1) activities continued to be higher than those in normal control group for a week after ADA levels were normalized.
CONCLUSION
The measurements of plasma ADA and its isoenzymes, especially ADA(1) were useful for ALL diagnosis. But they were not valuable markers to discriminate between complete remission and incomplete remission. For the detection of relapse, it could be valuable measure ADA activities beyond 6 weeks after chemotherapy.
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