390 G. ROUSER, A. J. SAMUELS, D. HELLER, B. JELINEK 
interesting urine pattern that was obtained on three different occasions from the 
same patient (M. Kle. 2). The patient excreted a large amount of glycine with lesser 
amounts of other amino acids (compare with normal urine patterns of Figs. 105-108, 
part II). This finding was not characteristic of the disease, but rather was related to 
the urinary excretion characteristics of this particular patient. 
As noted above, a small number of patients with acute leukemia were studied, but 
pretreatment findings were difficult to obtain. Figs. 124 and 125 show the free amino 
acid patterns of leukocytes obtained on two separate occasions from a patient with 
the diagnosis of monocytic leukemia (S. Nie. 3). It is to be noted that the glutamine 
level of these cells was higher than seen in cells from patients with acute lympho- 
blastic and myeloblastic leukemia (Figs. 130-132). The cells from the monocytic 
leukemia patient had a distinctive amino acid pattern that is readily differentiated 
from the patterns seen in acute lymphoblastic and acute myeloblastic leukemia as 
can be seen by the comparison of Figs. 124 and 125 with Figs. 130, 131, and 132. 
A good illustration of the marked deviations that may be seen in plasma samples 
from some of the patients with acute leukemia is illustrated in Fig. 126. The plasma 
sample for this chromatogram was obtained from patient S. Nie. whose leukocytes 
are shown in Figs. 124 and 125. Marked elevations of the leucines, valine, glycine, 
and lysine are apparent. Fig. 127 illustrates the abnormal urine findings in the same 
patient (S. Nie.), and it is to be noted that there was a marked increase in both the 
leucine and valine areas on the chromatograms and a very large amount of histidine. 
In this patient there appeared to be an overall aminoaciduria. The free amino acid 
pool of the erythrocytes of patient S. Nie. are shown in Fig. 128. Spots to the left of 
alanine and glutamine on the chromatogram were not seen in normal individuals 
and have seldom been seen in other patients. 
The erythrocytes from a patient (A. May. 2) with acute lymphoblastic leukemia 
are illustrated in Fig. 129. The chromatogram is of particular interest in that glutamic 
and aspartic acids and glutathione are very high compared to the levels of other 

Figs. 115 and 116. Extracts of 0.3 ml of plasma and e1ythrocytes from a patient with chronic 
lymphatic leukemia. 
Figs. 117-122. Prepared from leukocyte extracts from patients with chronic lymphatic leukemia. 
Fig. 117 from extiact of too mg of leukocytes from bone marrow to show the relatively low 
glutamine level in the cells. Fig. 118 from extract of too mg of lymphocytes from peripheral 
blood of another patient to show the free amino acid pools of lymphocytes obtained from peri- 
pheral blood. Fig. 119, the same sample shown in Fig. 118 after oxidation with hydrogen peroxide 
(the arrow points to the inciease in oxidized glutathione). Fig. 120, from an extract of 100 mg of 
lymphocytes from a bone marrow aspirate from the patient whose peripheral blood leukocytes 
are shown in Figs. 118 and 119 (arrow to glutamine). Fig. 121 prepared from an extract of 100 mg 
of lymphocytes fiom peripheral blood of another patient to show the marked similarity of the 
lymphocyte free amino acid pattern in this case to the pattern seen with lymphoblasts from 
acute lymphoblastic leukemia (Figs. 130, 131). Arrows from above down to taurine, glutamine, 
glutamic acid, and ethanolamine-O-phosphate. Fig. 122 from an extract of 100 mg of lymphocytes 
from the peripheral blood of another patient to show the variability in the free amino acid pool 
of the morphologically similar cells (arrow to glutamine). 
Fig. 123. From an extract of 0.5 ml of urine from a patient with chronic lymphatic leukemia that 
illustrates the unusually large amount of glycine excreted. 
Fig. 124 and 125. From extracts of 165 mg and 100 mg of monocytes removed from the peripheral 
blood of a patient with monocytic leukemia. 
Fig. 126. Shows the marked alterations in free amino acids of plasma (extracts of 0.5 ml) from 
the patient with monocytic leukemia. The arrows point to the high levels of (from above down) 
the leucines, valine, glycine, and lysine. For abbreviations see p. 369. 
References p. 447/448 
