OCCURRENCE OF FREE AMINO ACIDS — VERTEBRATES 
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FREE AMINO ACIDS IN THE BLOOD OF MAN AND ANIMALS 
III. CHRONIC LYMPHATIC AND ACUTE LEUKEMIAS 
GEORGE ROUSER, ARTHUR J. SAMUELS, DOROTHY HELLER 
AND BOHDAN JELINEK 
Departments of Biochemistry and Medicine, City of Hope Medical Center, 
Duarte, Calif. (U.S.A.) 
Previous parts of this series present the general methods of study of free amino 
acids of blood and the results obtained with untreated patients with chronic granulo- 
cytic leukemia and polycythemia. This part presents the results obtained from the 
study of untreated patients with chronic lymphatic leukemia and acute leukemia. 
PATIENTS STUDIED 
Eight patients with chronic lymphatic leukemia were studied. 4 of these patients 
had no previous form of treatment. The other 4 patients had been treated at some 
time prior to our studies. All of the patients had high lymphocyte counts and other 
features typical of chronic lymphatic leukemia. As the platelet levels were very low 
in these patients, no platelet samples were examined in the present series. Three of 
the patients with chronic lymphatic leukemia were studied on numerous occasions. 
One was studied for a period of 6 months, another for a period of I year, and I patient 
was followed for 2 years. These longer term studies were in connection with the effects 
of administration of various drugs that will be discussed in part IV. 
A total of 174 blood samples, 45 bone marrow aspirates, and 23 urine samples 
were examined from patients with chronic lymphatic leukemia. Five patients with 
acute leukemia were studied. These studies were generally less satisfactory than the 
chronic leukemia studies because of the necessity for prompt clinica] intervention 
with blood transfusions and other forms of therapy that made it impossible to obtain 
adequate pretreatment examinations. Some deviations from the normal free amino 
acid levels were observed in blood from these patients. Since the changes caused by 
therapy could not be studied separately, only illustrative examples will be given of 
findings that indicate how extensive the deviations from normal may be in acute 
leukemia. 
RESULTS AND DISCUSSION 
Figs. 115 and 116 illustrate fairly typical findings in plasma and erythrocytes, 
respectively, from an untreated patient (R. Mon. 3) with chronic lymphatic leukemia. 
A number of other examples are given in parts IV and VI. No absolutely reproducible 
differences from normal were found for plasma or erythrocytes from untreated 
patients. The untreated chronic lymphatic leukemia patients showed greater fluctua- 
tions from one sample to the next than was observed for normal individuals. A 
consistent finding was a plasma glutamine level at the lower limit of the normal 
range as was observed for chronic granulocytic leukemia. The plasma glutamate 
References p. 447/448 
