Postirradiation Changes in the Levels of Organic Phosphorus in the Blood of Patients with Leukemia
Authors: Jules C. Abels, John M. Kenney, Lloyd Craver, L. D. Marinelli, C. P. Rhoads
Journal: Cancer Research (1941)

(Received for publication July 23, 1941) INTRODUCTION Tracer doses of radioactive phosphorus, pa._,, have been used by Lawrence and co-workers (4) to study the metabolism of phosphorus in leukernic mice. Law- rence was interested primarily in the distribution of pa.o among the various groups of phosphorus compounds in the animal tissues. It seemed desirable, however, to extend his experiments to the leukemic patient and to measure, after the administration of small quantities of P'~, the concentration of both radioactive and non- radioactive phosphorus in the various phosphorus- containing fractions of the patient's blood cells. These fractions included the inorganic and organic acid- soluble (O.A.S.P.) compounds of the erythrocytes, of the leukocytes, and of  blood. It was noted that the ingestion of a subtherapeutic dose of approximately i. 5 me. of radioactive phos- phorus, W'-', by the first of the patients investigated was followed by a rapid increase in the concentration of the organic acid-sohlble phosphorus compounds of the erythrocytes. Subsequently, an increased concen- tration in both erythrocytes and leukocytes as a sequel to the administration of p3._, was observed in 4 other leukemic patients, but it has not followed the adminis- tration of nonradioactive phosphorus to the same individuals. It was desirable to establish whether the observed change in the organic acid-soluble phosphorus levels of the blood cells was due to the radioactivity of the P:~' or to some chemical property of this isotope. If to * This investigation was aided by a grant from The Jane Coffin Childs Memorial Fund for Medical Research. ~ Read at the 92nd Annual Session, American Medical Asso- ciation, Section on Radiology, June 6, I94 I, Cleveland, O. + Finney-Howell Foundation Medical Research Fellow. w Fellow of the Rockefeller Foundation. the former, similar changes would be expected after the administration of comparable doses of x-rays. Accordingly, such doses were administered to several patients by two methods of external irradiation. The first method used was  body irradiation. 1 This was chosen because it distributes the radiation throughout the entire body, a distribution comparable to that effected by the administration of P:3. The second method was the direct exposure of the cardiac area, and was employed to ascertain the change in organic acid-soluble phosphorus levels which followed irradiation essentially limited to the circulating blood. METHODS The concentrations of inorganic phosphorus and of organic acid-soluble phosphorus compounds of  blood, erythrocytes, and leukocytes were measured by the method of Fiske and Subbarow (2). The erythrocytes and thc lcukocytes were readily separated from the  blood of leukemic patients. The cells from 20 co. of  oxalated blood were allowed to settle for 15 minutes. The sedimentation rate of the red cells of leukemic blood is nmch more rapid than that of the leukocytes, which thus remained suspended in the supernatant plasma. The plasma, with its contained leukocytes, was pipetted carefully into a centrifuge tube, and then centrifuged at 3,000 r.p.m, for 15 minutes. The supernatant cleared plasma was removed as completely as possible, and the packed white cells resuspended in 5 cc. of isotonic saline. The concentration of white cells in this suspension was determined by its hematocrit value. Similarly, a sus- 1 This was administered in the  (I) unit of the Me- morial Hospital. In this communication, Heublein is synony- mous with whole body radiation. 771