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Metabolic Studies on Folic Acid in Malignancy¹

Radiumhemmet, the Department of Internal Medicine, and King Gustaf V Research Institute, Karolinska Sjukhuset, Stockholm, Sweden

Plasma clearance of folic acid was studied in 25 patients, 19 of whom were selected early cases of malignancy with unimpaired general condition; 23 of these patients, including 17 with early tumors, had an accelerated clearance rate. On an average, the clearance of folic acid in plasma was more rapid in patients with low serum iron or hemoglobin concentration.

Pathologic values for the FIGLU² excretion were recorded in 10 out of 22 patients; there was no correlation between the excretion of FIGLU and the serum concentration of folic acid.

Six days after administration of large doses of folic acid the SFAA was well above the value for the normal controls, and the FIGLU excretion was considerably diminished in 6 out of 7 patients examined; the clearance rate of folic acid was, however, only slightly changed and not normalized.

The changes in folic acid metabolism observed in cases of malignancy are probably due to an increased demand for folic acid.

¹ This study was supported by a grant from the Swedish Cancer Society.

² The following abbreviations are used: SFAA, folic acid activity in serum; FIGLU, formiminoglutamic acid; PGA, pteroylglutamic acid.

Received 5/17/65.