Red cell enzymopathies in leukemias

Red cell glucose-6-phosphate dehydrogenase (G6PD) and pyruvate kinase (PK) levels were estimated in patients with leukemias, to see if there was a consistent enzyme defect and correlation of enzyme levels with stage of the disease with prognostic assessment. G6PD levels were found to be significantly increased or decreased in majority of the patients with acute leukemias. Increased activity was seen in majority of the patients with L1 and decreased activity in L2 subtype of acute lymphocytic leukemia (ALL). In chronic myeloid leukemia (CML) G6PD activity was consistently increased, with levels being highly elevated in chronic phase and moderately in blast phase. Variation in G6PD activity was found to be related to the stage of disease and was of prognostic significance. PK was found to be normal or decreased. Fetal haemoglobin levels were also estimated in 30 patients with leukemias and were found to be elevated in most patients. Red cell G6PD may be useful for staging of the disease, as prognostic indicator and predictor of relapse.