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Levels of Serum Ribonuclease as an Indicator of Renal Insufficiency in Patients with Leukemia¹

The Oncology Center, The Johns Hopkins University School of Medicine, The Baltimore City Hospitals, Baltimore 21224 [R. L. H.], and The Baltimore Cancer Research Center, National Cancer Institute, Baltimore, Maryland 21211 [T. P. K., E. A. N., C. C. L.]

Serum ribonuclease (RNase) levels were measured in 29 patients with leukemia at various times during their illness and compared with 54 normal controls and 28 nonleukemic patients on chronic hemodialysis. Eighty-three % of the leukemic patients examined before therapy and with normal rates of glomerular filtration (as defined by creatinine clearance greater than 60 ml/min) had RNase levels that fell within the mean ± 2 for the normal controls. Sixty-one % of the leukemic patients, studied at various times during the course of their illness, who had a creatinine clearance of >60 ml/min had RNase levels in the normal range. Ninety-three % of the leukemic patients studied with a creatinine clearance of <60 ml/min had RNase levels above the range established for the normal controls. Patients without leukemia, but on hemodialysis for chronic renal failure of varied etiologies, had markedly elevated serum RNase levels. A strong correlation between RNase levels and renal insufficiency is therefore demonstrated, illustrating that changes in RNase levels over periods of time depend on the rate of glomerular filtration and are not related to the extent of leukemia. The enzyme responsible for enhanced RNase activity as glomerular filtration rate declines is shown to be antigenically similar, if not identical, to the enzyme found in normal human plasma. In conclusion, serum RNase levels are an indication of the rate of glomerular filtration and are not a biomarker for the presence or extent of leukemia.

¹ This research was supported in part by USPHS, National Cancer Institute Grant CA 06973 and Contract N01-CM-43718 and by American Cancer Society Grant PDT-53.

² To whom requests for reprints should be addressed.

³ Present address: Division of Neurosurgery, University of Texas Southwestern Medical School, Dallas, Texas 75235.

Received 12/13/76. Accepted 4/11/77.