Neopterin concentration in patients with chronic lymphocytic leukemia depending on infectious complication etiology

Relevance. In different diseases, when the cell immune system is involved into the pathogenesis and/or is affected by a respective pathologic process, neopterin concentration reflects the disease progression and can be used in clinical practice for early diagnosis of one or another type of an infectious complication of chronic lymphocytic leukemia (CLL), for achievement of an optimal result of prognostic and diagnostic measures, for reduction of the number of recurrences and for well-timed ordering of preventive treatment. Study objective. To examine neopterin concentration in patients with chronic lymphocytic leukemia at different stages of the main disease progression, as well as depending on the etiological factor of the infectious complication and its form (localized or generalized). Material and methods. Data of 177 patients with CLL were analyzed. Methods for examining etiologic agents of infectious complications were applied according to Order No.535 "On Unification of Microbiological (Bacteriological) Examination Methods, Applied in Treatment and Diagnostic Laboratories of Medical and Preventive Institutions" dated April 22, 1985. ELISA method was applied to identify antibodies (IgM and IgG) to the viruses Varicella zoster, Cytomegalovirus (CMV). Neopterin concentration in the blood serum was measured with ELISA method with the use of test systems "Neopterin ELISA" of IBL INTERNATIONAL GMBH Company, Hamburg, Germany. Results. Differences in neopterin concentration depending on CLL phase are as follows: the maximum increase of its level in the active phase (60.84±2.77 nmol/l), and an increase of neopterin level in the newly diagnosed patients (42.44±3.59 nmol/l) in comparison with the group of outpatients (stable phase 32.76±2.23 nmol/l). Prevalence of the influence of bacteriological agents on neopterin concentration was revealed (76.59±2.82 nmol/l), which is 3 times higher than under viral complications of CLL (22.10 ± 0.93 nmol/l). Mycotic complications of CLL caused an increase of neopterin level in the blood serum up to an average of 33.38 ± 1.68, which is connected both with specific immunologic mechanisms of combating this group of complications. Under the onset of additional infectious complications demonstrated significant exceeding of neopterin level indicators, especially those that progress with generalization of the pathologic process - a 1.5-2 increase in comparison with the local processes. Findings. Analysis of neopterin average concentrations in the blood serum of patients with CLL under infectious complications of bacterial, viral and mycotic etiology identified a significant increase of neopterin average level under all types of pathogens, complication forms and CLL stages in comparison with the group of patients without infectious complications. There is credible evidence of a statistically significant effect of each type of agents on the increase of neopterin level in the blood serum, including at the stage of symptomless manifestation of complications.

chronic lymphocytic leukemia, neopterin