Isoamylase levels in bone marrow transplant patients are affected by total body irradiation and not by graft-versus-host disease.
The mean total serum amylase levels in patients was 3.2 +/- 0.5 mukat/l (+/-SE) before total body irradiation (TBI) prior to bone marrow transplantation of which 50% was due to pancreatic isoamylase and 50% salivary isoamylase. Total serum amylase increased to a maximum of 100.3 +/- 12.3 mukat/l on the first day after TBI and most of this increase was due to an increase in salivary isoamylase (90.0 +/- 12.1 mukat/l). In association with this, all patients had clinical symptoms of parotitis. An increase in pancreatic isoamylase was found in 27% of the patients; however, none of them had clinical symptoms of pancreatitis. Serum amylase levels returned to normal within 5 days after TBI but then decreased to subnormal values, remaining below the normal range for 3 weeks. Pancreatic isoamylase returned to pre-irradiation levels 1.5 months after TBI, while salivary isoamylase remained low for the rest of the observation time. TBI of 7.5 Gy at 26 cGy/min gave significantly lower salivary amylase at 2 days after TBI compared with 10 Gy at 4 cGy/min: 32 +/- 4 versus 76 +/- 13 mukat/l (P less than 0.05). At 2.5 and 6 months after TBI significantly higher total amylase levels were recorded for patients treated with 7.5 Gy of TBI compared with 10 Gy: 2.5 +/- 0.4 and 2.7 +/- 0.3 versus 2.0 +/- 0.5 and 0.8 +/- 0.3 mukat/l, respectively (P less than 0.01, P less than 0.05, respectively). Acute or chronic GVHD did not affect acinar cells in this investigation.
Brattström
C
C
Department of Transplantation Surgery, Karolinska Institute, Huddinge Hospital, Sweden.
Tollemar
J
J
Ringdén
O
O
Bergström
K
K
Tydén
G
G
D000293:Adolescent; D000328:Adult; D000681:Amylases / Q000097:blood; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D006086:Graft vs Host Disease / Q000201:enzymology*; D006801:Humans; D007517:Isoamylase / Q000097:blood* / Q000528:radiation effects*; D007938:Leukemia / Q000201:enzymology / Q000532:radiotherapy; D008875:Middle Aged; D012463:Saliva / Q000201:enzymology / Q000528:radiation effects; D014916:Whole-Body Irradiation
D000681:Amylases; D007517:Isoamylase