Urinary Neopterin as a Prognostic Factor in Haematological Neoplasias

Abstract

In 1981 /82 we have reported that urinary neopterin concentrations were increased with high frequency in patients with haematological neoplasias. Seven years after this first report we have investigated whether the magnitude of the measured neopterin increase was associated with the subsequent survival of these patients. Complete clinical follow up data were available of 85 out of 115 patients initially investigated in this study. Overall, Kaplan-Meier analyses show that patients with Hodgkin's disease had the best prognosis compared to patients with non-Hodgkin's lymphoma and chronic myelogenous leukaemia. Hodgkin's patients had, on average, also lower urinary neopterin levels than the other patients. Higher neopterin concentrations were associated with worse prognosis in patients with Hodgkin's disease (p = 0.04, Breslow test) and with nonHodgkin's lymphoma (p = 0.035). In patients with chronic myelogenous leukaemia survival probability was lower in patients with higher neopterin concentrations 2 years after neopterin measurement (p < 0.01). Later on, no difference of survival was observed. Markedly decreasing survival was seen after an observation period longer than 4 years in both groups. Multivariate analyses show that the predictive value of neopterin concentrations was independent from stage of disease. We conclude that neopterin concentrations are of predictive relevance in patients with haematologic neopiasias.