In 80 patients with different platelet counts serum and plasma potassium concentration was measured, 30 minutes after blood sampling and three and six hours of storage. Serum and plasma concentrations differed, depending on the platelet count. In reactive thrombocytosis the mean difference was 0.7 mmol/l, independently of the time since sampling. In myeloproliferative diseases and with platelet counts of more than 1000 X 10(9)/l is was time-dependent. The mean difference was between 0.8 and 1.8 mmol/l, in individual cases as much as 2.6 mmol/l. Plasma potassium levels were independent of time and platelet count. The possibility of pseudohyperkalaemia in serum must be kept in mind whenever the platelet count is increased, regardless of its cause. In case of doubt potassium must be measured in platelet-free plasma.

Untreated patients with Hodgkin’s lymphoma in stages I-IIIA with risk factors (large mediastinal mass, massive splenic involvement, extranodal disease) were entered into the HD1 protocol and received a combined chemoradiotherapy [2 × (COPP+ABVD) + 40 Gy extended field irradiation (EF) vs 2 × (COPP+ABVD) + 20 Gy EF]. Patients in stages IIIB/IV (HD3 protocol) received induction chemotherapy [3 × (COPP+ABVD)] and were randomized into consolidation by radiotherapy [20 Gy involved field irradiation (IF)] vs chemotherapy [1 × (COPP+ABVD)]. Seventy-three of 89 evaluable patients (82%) treated according to the HD1 protocol achieved a complete remission. Freedom from progression and survival of patients in stages I-IIIA with risk factors treated according to HD1 were no worse than those of patients in stages I and II without risk factors who received only radiotherapy. Eighty-six of 137 patients (63%) treated according to the HD3 protocol achieved complete remission after induction chemotherapy with COPP+ABVD. This is significantly better than the 31% complete remission rate observed in a previous pilot study with COPP alone (P < 0.01). Including salvage therapy (radiotherapy in case of persisting nodal disease; chemotherapy with 4 × CEVD in case of persisting disseminated disease), a total of 76% complete remissions in stages IIIB/IVAB were achieved. A high erythrocyte sedimentation rate (> 80 mm h−1) was the most significant risk factor for achieving freedom from progression.

In 10 patients with heavily pretreated Hodgkin's disease (stage IVA or IVB) a third-line salvage therapy consisting of CCNU, etoposide and chlorambucil (CECh) was tested. All patients were resistant to both COPP and ABVD. Acceptance and tolerance of CECh were very satisfactory. The observed response rate (3 complete remissions and 4 partial remissions) is encouraging. The survival time after CECh therapy is in excess of 32 months (complete remission) and 15 months (partial remission). The main possible adverse effect is a prolonged myelosuppression. The CECh therapy is an effective alternative chemotherapy in patients resistant to both COPP and ABVD, moderately toxic, easy to administer and well tolerated in heavily pretreated patients.

Abstract Several side‐effects of asparaginase therapy have been said to be a consequence of the glutaminase activity of Escherichia coli asparaginase, especially the deleterious influence on the liver function. We report here the drug‐induced impairments of asparagine and glutamine metabolism in correlation to concentrations changes of plasma proteins, synthesized in the liver, in patients with acute lymphatic leukaemia. One hour after asparaginase application, plasma glutamine decreased to 5% (0–39%: median, range) of the initial values, with a subsequent rise to concentrations slightly lower than those prior to therapy. During the 14 days of drug application the fasting plasma concentrations of glutamine fell to a median of 63% of the pre‐therapeutic levels, indicating a depletion of the glutamine pools. Two days after the end of asparaginase application, in one patient the glutamine concentrations increased to the pre‐therapeutic range. Plasma concentrations of fibrinogen and antithrombin III decreased to 46% and 56%, respectively, of the initial values, with a slight increase 2 days after the end of therapy. The changes of plasma protein concentrations followed the course of plasma glutamine and asparagine. From that we deduce that the hepatic synthesis of the plasma proteins might be influenced by asparagine and glutamine depletion as a consequence of the therapy with E. coli asparaginase.

Malnutrition is one of the typical consequences of tumor burden and tumor therapy. Its first clinical manifestations are weight loss in adults and failure to gain weight in children. The etiology of cancer patients’ malnutrition is multifactorial, and, as yet, incompletely understood.

Cell membrane fluidity (CMF), Ig receptor expression and ecto-ATPase activity were investigated in lymphocytes from patients with chronic lymphocytic leukemia (CLL) and from healthy controls. Significant differences were observed in the parameters of individual CLL cases as compared to normal controls. These findings suggest that malignant transformation of lymphocytes to CLL cells is accompanied by disturbances in cell membrane structure and function, which can be modulated to some extent by exogenous influences on the lipid composition of the cell membrane. The results also suggest, however, that CLL is apparently an inhomogeneous disease with major variations in the investigated parameters among individual cases.