Application of 31P NMR spectroscopy in clinical analysis of changes of serum phospholipids in leukemia, lymphoma and some other non-haematological cancers.

The sodium salt of cholic acid added to serum caused separation of three phospholipid peaks located upfield from inorganic phosphate (Pi) due to phosphatidylethanolamine with sphingomyelin (PE+SM), lysophosphatidylcholine (LPC), and phosphatidylcholine (PC). 31 P NMR spectra were obtained from the sera of 15 healthy volunteers, 10 individuals suffering from acute leukemia, 4 persons with malignant lymphomas, 13 patients with digestive tract tumors and 5 with renal cell carcinoma. The present studies confirmed our previous observation that the 31 P spectra of sera of patients with acute leukemia and malignant lymphomas revealed a significant decrease in the phospholipid level at the time of diagnosis and displayed a good correlation between spectral parameters and stage of disease in patients responding and non-responding to therapy. Contrary to the preliminary studies, peaks from PE+SM and PC, and also a peak from LPC were observed. Changes in phospholipids in the 31 P NMR spectra observed in patients suffering from digestive tract tumors and renal cell carcinoma were primarily dependent on the advance of the disease. Most of our patients with these cancers were in the early stage of the disease, and the spectra showed statistically significant decrease only in the LPC peak area, and no statistically significant changes of peak areas of PC and PE+SM in comparison to the control group. In conclusion, we can state that the LPC peak area is the most sensitive indicator in the monitoring of treatment in acute leukemia and malignant lymphomas. Our results also showed that LPC peak areas were decreased in the early stages of digestive tract tumors and a renal cell carcinoma.