414 G. ROUSER, K. KELLY, B. JELINEK, D. HELLER 
of the individual since fluctuations were observed. Similarly, the differential counts 
and total white counts given in Table II were chosen as more or less representative 
for the patients before treatment. As shown in the table, a number of blood samples 
were examined from each patient. One patient was studied on four consecutive 
occasions after administration of dimethylmyleran, while two others were studied 
on two consecutive occasions, and the response of two other patients was studied 
for several months after a single administration of dimethylmyleran. One of the 
patients that was studied twice with dimethylmyleran was also given myleran and 
CB 2432, an isomer of dimethylmyleran, while one patient was given myleran, 
CB 2432, and a less active pentane myleran isomer for comparison. Each blood 
sample was divided into plasma, platelets, leukocytes, and erythrocytes when this 
was possible. Platelet samples were frequently too small and leukocyte samples 
were unobtainable when the counts were reduced after drug administration. 
Dimethylmyleran was injected intravenously. It was dissolved by warming in 
aqueous ethanol and mixed with saline just prior to injection. Myleran was given 
orally. 
RESULTS AND DISCUSSION 
The general findings in untreated patients with chronic granulocytic leukemia are 
described in part II and further examples of the deviations from normal are apparent 
in the pretreatment control studies presented here. A summary of the effects of the 
drugs on free amino acids of plasma, erythrocytes, and leukocytes in the patients is 
presented, followed by detailed documentation of the responses of two patients to 
illustrate the extent of the changes. 
Effects of dimethylmyleran and myleran on free amino acid levels of plasma 
The individual response of the patient and the dosage level determined the magnitude 
of the changes in free amino acid levels and the total leukocyte count. It is to be 
emphasized that maximum changes in plasma were not always detected where 
maximum changes in leukocytes and erythrocytes were observed. Marked changes 
were observed in either plasma, erythrocytes, or leukocytes of some patients without 
similar changes being apparent in the other samples from the same patient. 
The plasma changes varied from almost no definite deviation from the control 
level to the marked changes described below for patient R. Tap. (Figs. 250-267 p. 426). 
Four consecutive studies with patient H. Gol. with dimethylmyleran disclosed only 
minimal effects in plasma, consisting of a decrease of glutamic and aspartic acids. 
In only one patient (M. Fal.), at a low dosage level of dimethylmyleran (5 mg), was 
no effect observed in the plasma. Almost no effect was observed in the plasma of pa- 
tient R. Tho. with chronic lymphatic leukemia (see Figs. 195-204). Intermediate 
effects on plasma free amino acids were related almost exclusively to marked drops 
in aspartic and glutamic acids and taurine. Taurine was not detected in patients 
M. Fal. and D. Fol. before drug administration. The most marked effects on plasma 
free amino acids are illustrated in Figs. 250-267. This patient showed not only 
the decreases of glutamic and aspartic acids and taurine observed in the other pa- 
tients, but decreases in most of the other free amino acids as well. Alanine was decre- 
ased to a great extent and lesser decreases in the levels of valine, the leucines, glycine, 
and serine are apparent. From these findings it is evident that the major, consistent 
References p. 447/448 
