Assessment of biochemical tests for bone and liver involvement in malignant lymphoma patients

A profile of biochemical tests was performed on 72 patients attending a lymphoma clinic. Urinary hydroxyproline excretion was increased in 24 cases at the outset; of these ten had positive clinical or radiological evidence of bone disease at that time, and in a further ten such evidence became available over the next two years. Hepatic involvement was detected among 9 patients at the initial examination. All of these, and a further five who developed liver involvement over the next two-year period had raised activity of serum 5'-nucleotidase. Total serum alkaline phosphatase was raised in 8 of the 9 patients with initial involvement, but only 1 of the 11 patients who subsequently developed hepatic disease; the heat stability test indicated the presence of the hepatic isoenzyme in these cases. Alkaline phosphatase was raised in 10 of the 20 cases with initial or subsequent evidence of bone disease, heat stability indicating the bone isoenzyme to be predominant. Serum ornithine transcarbamoylase was raised in only 7 patients with initial hepatic involvement, and the aminotransferases were not helpful in identifying lymphomatous involvement of the liver.