Haemoglobin and red cell enzyme changes in juvenile myeloid leukaemia.

The switchover from foetal to adult haemoglobin synthesis, which is normally complete by the end of the first year of life, is accompanied by marked changes in the red cell enzyme pattern. In particular, the level of carbonic anhydrase, which is very low in cord blood, rapidly increases during the first year of life to become the most abundant of the red cell nonhaemoglobin proteins. There have been occasional reports of the presence of increased levels of foetal haemoglobin in the red cells of patients with leukaemia (Beaven et al., 1960; Shuster et al., 1960; Hardisty et at., 1964; Weatherall and Walker, 1965). While a slight rise of foetal haemoglobin is not uncommon in a variety of leukaemias, very high levels have been noted only in patients with erythroleukaemia (Beaven et al., 1960) and in children with juvenile myeloid leukaemia (Hardisty et al., 1964). The occurrence of associated changes in red cell enzyme levels has not been noted. This report describes the changes in haemoglobin and red cell enzyme patterns over a 12-month period in a child with the clinical features of juvenile myeloid leukaemia and similar studies on 27 children with other types of leukaemia. These studies shed further light on the pathogenesis of juvenile chronic myeloid leukaemia.