Clinical relevance of polyamines as biochemical markers of tumor kinetics

The polyamines, spermidine and spermine, and their di-amine precursor, putrescine, constitute a unidirectional biosynthetic pathway whose biosynthetic enzymes and accumulation patterns appear to play important roles in the regulation of growth processes. Concentrations of these compounds in physiological fluidsare low or unde-tectable under normal conditions, are elevated in patients with metastatic cancer, and are thought to reflect growth (putrescine concentrations) and cell turnover (spermidine concentrations) of the organism. Cancers are a broad spectrum of diseases in which there are altered growth fractions and cell-turnover fractions, and therefore cancer chemotherapeutic agents have been developed to take tumor kinetics into account. Because changes in poly-amines in physiological fluids reflect cell kinetics, this review compiles evidence of their efficacy as biochemical markers of cancer and suggests their possible usefulness to clinicians in rapidly assessing tumor response to che-motherapy or to multimodality therapy. Additional K.yphrases: cancer #{149}monitoring therapy #{149}column chromatography #{149}diagnostic aids #{149} screening #{149}spermidine, spermine, putrescine As early as 1889, studies suggested that more poly-amines appear in urine in certain pathological states. Using simple chromatographic procedures, Udr#{226}nszky and Baumann (1) detected putrescine and cadaverine in the urine of patients with cystinuria (1, 2). The presence of cadaverine suggested bacterial contami-nation of the urine, because it is not found in mammals to any substantial extent (3). The excretion of spermi-dine by patients with cystinuria and other conditions was not reported until almost a century later, when more sophisticated ion-exchange techniques were used to separate and estimate diamines and polyamines in biological material (4, 5)