Serum vitamin B12-binding capacity and muramidase changes with cyclic neutropenia induced by cytosine arabinoside.

A patient with acute leukemia in sustained complete remission was studied for 8 months. Periodic maintenance chemotherapy with cytosine arabinoside regularly induced granulocytopenia, with granulocytosis upon marrow recovery. Changes in serum unbound B 12 -binding capacity (UBBC) occurred simultaneously with peripheral granulocyte fluctuations. Both α- and β-globulin UBBC were affected. Serum muramidase rose and fell out of phase with the granulocyte and UBBC fluctuations, preceding them by several days. These data support the concept that serum UBBC and serum muramidase reflect different aspects of granulocyte activity.

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