Neopterin excretion levels were assessed in 66 consecutive patients affected by non-Hodgkin's lymphomas (NHL). The logarithm of the mean value of the whole series was 2.71 (log [pmol neopterin/mol creatinine]), significantly higher (P < 0.001) than the control value (2.12). Fifty-six of 66 patients had a raised excretion of neopterin in amounts statistically related to the stage of disease. The mean value (2.51) of patients in Stages 1-11 was lower than the mean value (2.86) of patients in Stage 111-IV (P < 0.001). The 2-year probability of survival was 64% for patients in Stages 1-11 and 34% for patients in Stages 111-IV. However, patients with lower neopterin excretion (~2.65) fared better than patients with higher neopterin excretion, regardless of the stage. Longitudinal analysis showed a trend toward a correlation between response to therapy and neopterin excretion. In NHL, the raised neopterin excretion appears to be a consequence of activation of the host immune system rather than a product of the malignant cells. But this excessive activation of the monocytes-macrophages, as reflected by urinary neopterin levels, is not accompanied by a better outcome. In conclusion, although neopterin cannot be considered a typical tumor marker, nevertheless it is an useful prognostic marker in NHL.
Cancer 63A84-489, 1989.
ON-HODGKINS LYMPHOMAS (NHL) are hematologic N malignancies extremely heterogeneous with respect to clinical course, response to therapy and survival of pa- tients. Therefore, all of the histopathologic classifications utilized for diagnostic purpose have also the aim of relating morphologic or functional features of tumor cells to prognosis. The Ann Arbor staging classification,' proposed initially for Hodgkin's disease and utilized also for NHL, may sometimes be inadequate because it does not reflect the actual tumor mass of each patient. Particularly in early stages a bulky tumor mass and the number of nodal sites involved may influence negatively the outcome of patients.* Therefore, several biological markers have been evaluated in an attempt to add further informations to the clinical course and prognosis of patients affected by NHL.3-5 Neopterin is a pteridine compound derived from guanosine triphosphate (GTP). In the reduced form di-