Urinary neopterine in the assessment of lymphoid and myeloid neoplasia, and neopterine levels in haemolytic anaemia and benign monoclonal gammopathy.

The urinary neopterine levels were measured by HPLC in 417 normal subjects and in 216 patients with haematological diseases. All patients with active malignancies (multiple myeloma, polycythaemia vera. Hodgkin's lymphoma, non-Hodgkin's lymphoma, chronic myelocytic and chronic lymphocytic leukaemia) showed highly elevated mean and median values compared to the control groups. Those of patients with multiple myeloma stage I were only raised to near the upper limit of healthy subjects. Of 123 patients with active disease 105 (85%) were above the upper limit. In contrast, the mean and median values of 56 patients with neoplasias in remission (Hodgkin's and non-Hodgkin's lymphoma, acute leukemia and multiple myeloma) were not different from those of healthy subjects, and only 7 (12.5%) of these patients had levels above the upper limit. In patients with non-malignant diseases (haemolytic anaemia and benign monoclonal paraproteinaemia) the mean and median values were not raised. In patients with non-Hodgkin's lymphoma and with chronic lymphocytic leukemia, the neopterine levels corresponded with the tumor stage. The present data suggest tht neopterine assay may supplement laboratory measurements in haematological diseases, providing helpful information.