Blood, 1960, Vol. 16, No. 4, pp. 1479-1490.
© 1960 American Society of Hematology, Inc.
Serum Protein Changes in Malignant Diseases.
I. The Acute Leukemias
JOHN L. FAHEY 1 and
DANE R. BOGGS 1
1 General Medicine Branch, National Cancer Institute, (National Institutes of
Health, U. S. Public Health Service, Department of Health, Education and Welfare),
Bethesda, Md.
A study of the serum protein changes and clinical events in acute myeloblastic and acute lymphoblastic leukemia was undertaken as a part of investigations on the effects of malignancies in man. In order to appraise the effects
of the leukemic processes, an evaluation of the effects of disease type, activity,
complications and therapy was also undertaken. Over a five-year period, clinical appraisal and electrophoretic serum protein analyses were compared 171
times in 82 patients with acute lymphoblastic leukemia and 64 times in 28
patients with acute myeloblastic leukemia.
Serum electrophoretic evaluation showed characteristic patterns in
the two types of acute leukemia studied. Analyses conducted in the absence of fever, infection or liver disease typically revealed elevation of the
gamma globulins in myeloblastic but not in lymphoblastic leukemia. Alpha-2
globulin elevation, however, was representative of active lymphoblastic leukemia. Serum albumin was significantly lowered, and the beta globulins
component remained essentially normal in both myeloblastic and lymphoblastic leukemia. Alpha-1 and alpha-2 globulin values were notable for the
wide range of values obtained.
Hematologic remission in some patients with acute lymphoblastic leukemia
was associated with a return of albumin and alpha globulin values toward
normal, but the total experience indicated a general persistence during remission of the abnormalities seen in active diseases.
Fever, in the absence of infection, was associated with elevation of the
alpha-1 globulin component. Bacterial infection was associated with similar
elevation of the alpha-1 globulin fraction and, in addition, a further fall in
serum albumin levels.
Marked depression of the gamma globulins was unusual. The mild decreases encountered in lymphoblastic leukemia could not be related to the
frequency of bacterial infection. Administration of antimetabolites or adrenal
corticosteroids could not be shown to produce any direct effect on the serum
electrophoretic components.
Submitted on September 8, 1959
Accepted on April 15, 1960
