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体外和体内氨生成与淋巴恶性肿瘤成人中 L-天冬酰胺酶生物学活性的相关性。

Correlation of ex vivo and in vivo ammonia production with L-asparaginase biological activity in adults with lymphoid malignancies.

机构信息

Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, 830-0011, Japan.

Department of Clinical Laboratory Medicine, Kurume University Hospital, 67 Asahi-Machi, Kurume, 830-0011, Japan.

出版信息

Int J Hematol. 2024 Apr;119(4):426-431. doi: 10.1007/s12185-024-03718-y. Epub 2024 Feb 16.

Abstract

Silent inactivation of L-asparaginase (L-Asp) represents rapid clearance of L-Asp by anti-L-Asp IgG antibodies without clinical symptoms. Measurement of L-Asp activity is the gold standard for diagnosis of silent inactivation, but this test is not commercially available in Japan as of 2023. We evaluated ex vivo and in vivo ammonia production in relation to L-Asp activity. Blood samples from ten adult patients treated with L-Asp were collected to measure ammonia levels and L-Asp activity before the first dose and 24 h after the last dose of L-Asp, during each cycle of treatment. Plasma ammonia levels were analyzed immediately and 1 h after incubation at room temperature, and ex vivo ammonia production was defined as the increase in ammonia concentration. Ex vivo ammonia production correlated with L-Asp activity (R = 0.741), and ammonia levels measured immediately after blood collection were moderately correlated with L-Asp activity (R = 0.709). One patient with extranodal NK/T-cell lymphoma showed an increase in ammonia levels during the first cycle, but no increase in ammonia levels or L-Asp activity after L-Asp administration during the second cycle. Both ex vivo and in vivo ammonia production and surrogate markers are used for L-Asp biological activity.

摘要

L-天冬酰胺酶(L-Asp)的沉默失活表示抗 L-Asp IgG 抗体迅速清除 L-Asp,而无临床症状。L-Asp 活性的测量是诊断沉默失活的金标准,但截至 2023 年,该检测在日本尚未商业化。我们评估了氨生成与 L-Asp 活性的关系。收集了十个接受 L-Asp 治疗的成年患者的血液样本,以在首次剂量前和最后一次 L-Asp 剂量后 24 小时、每个治疗周期时测量氨水平和 L-Asp 活性。立即分析血浆氨水平,以及在室温孵育 1 小时后的氨水平,并将体外氨生成定义为氨浓度的增加。体外氨生成与 L-Asp 活性相关(R=0.741),并且采血后立即测量的氨水平与 L-Asp 活性中度相关(R=0.709)。一个患有结外 NK/T 细胞淋巴瘤的患者在第一个周期期间显示氨水平增加,但在第二个周期期间 L-Asp 给药后,氨水平或 L-Asp 活性没有增加。体外和体内氨生成以及替代标志物都用于 L-Asp 的生物学活性。

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