AMINO-ACID UTILIZATION AND URINE PROTEIN EXCRETION IN CHILDREN TREATED WITH SUCCINYLATED ACINETOBACTER GLUTAMINASE-ASPARAGINASE

  • 1 January 1981
    • journal article
    • research article
    • Vol. 41  (6) , 2056-2062
Abstract
Amino acid utilization was evaluated in 7 children with acute lymphocytic leukemia treated with succinylated Acinetobacter glutaminase-asparaginase. All patients received food ad libitum and glucose-electrolyte solutions i.v.; 4 patients received an i.v. amino acid supplement (1.5 g/kg/day). Although all patients were in negative energy balance, there was a significant linear regression between N balance and N intake during days 1-7 and days 8-14 of the study. The slope of the regression line, reflecting exogenous N utilization, was not significantly different from that found in healthy young men ingesting adequate or subadequate energy intakes. The Y-intercept (-210 mg/kg per day) indicated an obligatory N loss that was much greater than normal. Most of the N loss was due to urinary excretion. Ammonia and urea accounted for 77-91% of the urine N. Urinary glutamate accounted for 4-10% of this loss. Urine protein excretion was abnormally high in each of the patients, ranging from 987-3440 mg/day. Urine excretion of N-acetyl-.beta.-glucosaminidase and .beta.2-microglobulin was also abnormally high, despite normal blood urea N and serum creatinine, suggesting that these children had renal tubular dysfunction. The antileukemic effect of succinylated Acinetobacter glutaminase-asparaginase did not appear to be altered by amino acid supplementation. Amino acid supplementation can improve nutritional status in patients treated with succinylated Acinetobacter glutaminase-asparaginase.