Hypocholesterolemia is a well-documented phenomenon associated with a variety of hematological malignancies and nonmalignant disorders associated with splenomegaly. To determine the incidence of hypocholesterolemia in patients with hairy cell leukemia (HCL), we measured the serum cholesterol levels before and after a single cycle of 2-chlorodeoxyadenosine (2-CdA) in 46 patients. The mean pre-treatment serum cholesterol level was 152.8 mg/dl (range, 60 to 293 mg/dl). The mean post-treatment serum cholesterol level was 190.0 mg/dl. This was significantly higher than the pre-treatment values (P <0.0001). Twelve patients who had previously undergone splenectomy showed a similar response to treatment, with a pre-treatment value of 180.0 mg/dl and a post-treatment value of 219.8 mg/dl (P < 0.0001). However, there was a significant difference in the pre-treatment serum cholesterol levels in the nonsplenectomized patients (143.0 mg/dl) compared to the splenectomized patients (180.0 mg/dl) (P < 0.03). The pre-treatment serum cholesterol did not correlate with the pre-treatment splenic index (correlation coefficient = -0.39, P < 0.065). Similarly, there was no correlation between the change in splenic index and the change in serum cholesterol level post-treatment. These findings suggest that hypocholesterolemia in HCL is related to tumor burden and not to splenomegaly alone. Since cholesterol is critical to hairy cell metabolism and structure, treatment strategies interfering with cholesterol synthesis may be productive.

译文

低胆固醇血症是一种有据可查的现象,与多种血液恶性肿瘤和与脾肿大相关的非恶性疾病有关。为了确定毛细胞白血病(HCL)患者低胆固醇血症的发生率,我们测量了46位患者单周期2-氯脱氧腺苷(2-CdA)前后的血清胆固醇水平。治疗前的平均血清胆固醇水平为152.8 mg / dl(范围为60至293 mg / dl)。治疗后平均血清胆固醇水平为190.0 mg / dl。这显着高于治疗前的值(P <0.0001)。十二名先前接受脾切除术的患者对治疗表现出相似的反应,治疗前值为180.0 mg / dl,治疗后值为219.8 mg / dl(P <0.0001)。但是,未脾切除的患者(143.0 mg / dl)与经脾切除的患者(180.0 mg / dl)相比,治疗前血清胆固醇水平存在显着差异(P <0.03)。治疗前血清胆固醇与治疗前脾脏指数无关(相关系数= -0.39,P <0.065)。同样,治疗后脾指数的变化与血清胆固醇水平的变化之间也没有相关性。这些发现表明,HCL中的低胆固醇血症与肿瘤负荷有关,而与单独的脾肿大无关。由于胆固醇对于毛细胞的代谢和结构至关重要,因此干扰胆固醇合成的治疗策略可能会产生效果。

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