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BioMed Research International
Volume 2014 (2014), Article ID 945860, 6 pages
http://dx.doi.org/10.1155/2014/945860
Research Article

Clinical Utility of Ammonia Concentration as a Diagnostic Test in Monitoring of the Treatment with L-Asparaginase in Children with Acute Lymphoblastic Leukemia

1Department of Pediatric Oncology and Hematology, Children’s University Hospital, ul. Wielicka 265, 30-663 Krakow, Poland
2Department of Pediatric Oncology and Hematology, Polish American Institute of Pediatrics, Jagiellonian University Medical College, ul. Wielicka 265, 30-663 Krakow, Poland
3Department of Clinical Biochemistry, Polish American Institute of Pediatrics, Jagiellonian University Medical College, ul. Wielicka 265, 30-663 Krakow, Poland

Received 25 April 2014; Revised 7 July 2014; Accepted 11 July 2014; Published 23 July 2014

Academic Editor: Juan Manuel Mejía-Aranguré

Copyright © 2014 Małgorzata Czogała et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

L-asparaginase (ASP) is an enzyme used as one of the basic regimens in the acute lymphoblastic leukemia (ALL) therapy. Because of the possibility of the enzyme inactivation by antibodies, monitoring of ASP activity is essential. The aim of the study was to examine if plasma concentration of ammonia, a direct product of the reaction catalyzed by ASP, can be used in the assessment of ASP activity. A group of 87 patients with acute lymphoblastic leukemia treated in the Department of Pediatric Oncology and Hematology in Krakow was enrolled to the study. ASP activity and ammonia concentration were measured after ASP administrations during induction. A positive correlation was found between the ammonia concentration and ASP activity (; ) and between the medium values of ammonia concentration and ASP activity (; ). The analysis of ROC curves revealed the moderate accuracy of the ammonia concentration values in the ASP activity assessment. It was also found that the medium value of ammonia concentrations can be useful in identification of the patients with low (<100 IU/L) and undetectable (<30 IU/L) ASP activity. The plasma ammonia concentration may reflect ASP activity and can be useful when a direct measurement of the activity is unavailable.