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The Carbohydrate Metabolism of Leukocytes: A Review^*

( Department of Medicine, University of California Medical Center, Los Angeles, Calif.)

Both the older and the more recent literature would indicate that normal and leukemic myeloid cells are characterized by a substantial aerobic glycolysis. Conversely, lymphatic leukemic lymphocytes and blast forms have low aerobic glycolytic rates. Hence, it is improper to make conclusions regarding the neoplastic nature of leukemia on the basis of their "tumor metabolism."

The concept of "metabolism of injury" is also clearly hazardous, inasmuch as the claim that cells are injured is frequently based on the metabolic results obtained and on no other criteria. The absence of marked metabolic differences between intact cells and homogenates (7) and, in fact, the considerable difficulties in preparing leukocyte homogenates cast further doubt on the role of injury in producing a characteristic metabolic pattern.

It appears that normal myeloid leukocytes possess higher rates of respiration and glycolysis than do leukemic cells. It may be that leukocyte glycolysis suits these cells for existence in the comparatively anoxic environment of exudates. It has been shown (17) that phagocytosis persists in the presence of KCN as long as glucose is present. Fluoride and iodoacetate inhibit phagocytosis. Bone marrow is reported to have a similarly high aerobic glycolytic rate (16) and low oxygen consumption (23).

The problem of precisely what material to use as control in studying leukocyte abnormalities is admittedly far from solution. Ideally, leukemic lymphocytes should be compared to normal lymphocytes, blasts to blasts, and so on. As yet, such rigorous standards are all but unattainable, and one is forced to make inferences from more indirect approaches.

Leukocytes are extremely sensitive to the composition of the incubation medium. Recent results indicate certain qualitative and quantitative differences in the responses of normal and leukemic material to addition of various substrates and coenzymes. It is hoped that, in the light of more modern biochemical knowledge, further clarification may be brought to this problem.

^* This review was prepared in conjunction with work performed under Contract No. AT-04-1-GEN-12 between the Atomic Energy Commission and the University of California at Los Angeles.

Received 10/13/52.