Treatment-induced changes in 31P-MRS (magnetic resonance spectroscopy) spectra of sera from patients with acute leukemia

Low serum cholesterol levels predict inferior prognosis and improve NCCN-IPI scoring in diffuse large B cell lymphoma

Low circulating cholesterol concentration is associated with elevated cancer incidence and mortality. However, the association between cholesterol levels and diffuse large B cell lymphoma (DLBCL) remains unknown. The aim of our study was to evaluate the prognostic value of serum lipid profile in DLBCL. Five hundred and fifty enrolled subjects with detailed serum lipid levels at diagnosis of DLBCL were randomly divided into a training set (n = 367) and a validation set (n = 183) (ratio, 2:1). Multivariate Cox regression analyses screened the prognostic factors associated with progression-free survival (PFS) and overall survival (OS). Performances of models were compared using C-index and area under the curve in internal and external validation. The results showed that decreased levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were associated with unfavorable PFS and OS in the rituximab era, and concurrently low HDL-C together with low LDL-C was an independent prognostic indicator for both PFS and OS. Patients achieving complete remission or partial remission after 6-8 circles of chemotherapies had significantly increased cholesterol levels compared to the levels at DLBCL diagnosis, and HDL-C or LDL-C elevations were correlated with better survival. Furthermore, the predictive and discriminatory capacity of the National Comprehensive Cancer Network (NCCN)-International Prognostic Index (IPI) together with low cholesterol levels was superior to NCCN-IPI alone both in the training and validation set. In conclusion, serum cholesterol levels are simple and routinely tested parameters, which may be good candidates for predicting prognosis in the future clinical practice of DLBCL.

Application of 31P MRS to the analysis of phospholipid changes in plasma of patients with acute leukemia

The aim of the experiment was to evaluate the changes of phospholipid concentrations in patients (n=30) with acute leukemia compared with reference group of healthy volunteers (n=21). The analysis focused on the following phospholipids (PL) collected from plasma: phosphatidylcholine (PC), plasmalogen of phosphatidylcholine (CPLAS), lysophosphatidylcholine (LPC), sphingomyelin (SM), phosphatidylethanolamine (PE), and phosphatidylinositol (PI). Phospholipid extracts were obtained by Folch's method from 4 ml of plasma. 31P MR spectra were obtained on an AMX Bruker 300 MHz (7.05 T) spectrometer. Calculation of concentration based on integral intensity of the phospholipid relative to an internal concentration standard of MDPA. For healthy volunteers, the following values of phospholipid concentrations were obtained: (5.18+/-1.615) mmol/l for PC+CPLAS; (0.364+/-0.178) mmol/l for LPC; (1.211+/-0.411) mmol/l for SM; (0.343+/-0.124) mmol/l for PI+PE. PLs of patients were assayed at least twice: at the time of diagnosis and, when appropriate, at the time of complete remission from the disease (CR). At the time of diagnosis, the mean concentrations of studied compounds were: (1.602+/-0.716) mmol/l for PC+CPLAS; (0.041+/-0.048) mmol/l for LPC; (0.398+/-0.198) mmol/l for SM; (0.045+/-0.071) mmol/l for PI+PE. After attainment of complete remission (CR), the respective values were as follows: (4.094+/-1.886) mmol/l for PC+CPLAS; (0.295+/-0.139) mmol/l for LPC; (1.123+/-0.634) mmol/l for SM; (0.230+/-0.125) mmol/l for PI+PE. All concentrations found in patients at the time of diagnosis were significantly lower than in reference group and in those benefited from complete remission (CR). By contrast the differences in concentrations of phospholipids in plasma between patients with complete remission (CR) and healthy volunteers were no statistically significant.

31P NMR spectroscopy of blood plasma: determination and quantification of phospholipid classes in patients with renal cell carcinoma

Advanced renal cell carcinoma (RCC) has a poor prognosis and is characterized by an unpredictable clinical course. The aim of this study was to assess the systemic phospholipid distribution as a possible marker of tumor stage and tumor spread beyond the kidney. To this end, the effect of renal cell carcinoma (RCC) on phospholipid concentrations in blood plasma using 31P NMR spectroscopy was studied in: (a) 29 patients with RCC prior to nephrectomy; (b) 19 healthy volunteers; (c) three patients with other renal tumors (renal metastases of bronchial carcinoma and of renal pelvic carcinoma, and a benign renal tumor). Furthermore, the phospholipid concentrations of eight patients of group (a) were determined 6 months after nephrectomy, when they were in remission. We found considerable deviations in the concentrations of the lysophosphatidylcholines (LPC1, LPC2) in both male and female patients with RCC compared to healthy volunteers (male--LPC1 0.217+/-0.062 vs 0.297+/-0.049 mmol/l, LPC2 0.036+/-0.014 vs 0.068+/-0.024 mmol/l; female--LPC1 0.195+/-0.071 vs 0.296+/-0.044 mmol/l, LPC2 0.037+/-0.027 vs 0.044+/-0.014 mmol/l). In addition, female patients with RCC showed lower concentrations of phosphatidylcholines (PC; 1.409+/-0.268 vs 1.947+/-0.259 mmol/l). The low phospholipid concentrations normalized for patients in remission. Phospholipid concentrations were found to depend on tumor stage and metastatic spread. The deviations in phospholipid concentrations (LPC1, LPC2, PC) observed may be attributable to systemic effects caused by the tumor as well as changes in enzyme activities.

Systemic alterations in phospholipid concentrations of blood plasma in patients with thyroid carcinoma: an in-vitro (31)P high-resolution NMR study

In this study in-vitro (31)P high-resolution NMR spectroscopy of human blood plasma was optimized to obtain absolute concentrations of the major plasmaphospholipids: phosphatidylethanolamine plus sphingomyelin (PE + SM), 1- and 2-acyl-lysophosphatidylcholine (LPC1 and LPC2), phosphatidylinositol (PI) and phosphatidylcholine (PC). Plasma spectra of 33 patients with thyroid carcinoma were acquired at 121.49 MHz using a 300 MHz spectrometer. The patients were rendered hypothyroid (TSH >30 mU/l) in preparation for a whole-body scintigraphy. The whole-body scintigraphy showed tumour tissue or metastases in 16 patients (group C). Owing to an inconclusive whole-body scintigraphy, 17 patients were classified as being in remission (group B). After levothyroxine substitution 14 patients of group B were measured in euthyroidism too (group D). Besides these sub-groups, there was a control group made up of 23 healthy volunteers (group A). Group B showed significantly higher PE + SM and PC concentrations than group C (0.59 +/- 0.02 mmol/l PE + SM in B vs 0.48 +/- 0.02 mmol/l in C; 2.1 +/- 0.1 mmol/l PC in B vs 1.6 +/- 0.1 mmol/l in C). In comparison with group D higher concentrations of the phospholipids PE + SM and PC as well as PI were found in group B (0.59 +/- 0.02 mmol/l PE + SM in B vs 0.48 +/- 0.03 mmol/l in D; 0.074 +/- 0.005 mmol/l PI in B vs 0.046 +/- 0.004 mmol/l in D; 2.1 +/- 0.1 mmol/l PC in B vs 1.6 +/- 0.1 mmol/l in D). The data indicate that under the condition of hypothyroidism only patients in remission (group B) show significantly increased phospholipid concentrations, whereas the values in patients with remaining tumour tissue (group C) do not differ from those of the reference groups A and D. This finding is interpreted as an interference between the hormonal status and the systemic effects of cancer.