The
polyamines,
putrescine,
spermidine, and
spermine have been established as
biochemical markers of normal and pathological growth. In
malignancy, the urinary concentrations of
spermidine reflect the
tumor cell loss and the urinary level of
putrescine is related both to the number of
tumor cells in cell cycle and to the
tumor cell loss factor. A greater than twofold increase in urinary
spermidine within 72 hr of
chemotherapy predicts a complete or a partial response with a high degree of accuracy. Urinary
putrescine may be valuable, not only in assessing the early response to
therapy but also in determining whether the
chemotherapy promotes a later burst of cell proliferation. Erythrocyte
spermidine concentrations also appear to track alterations in
tumor kinetics. Alterations in intracellular and extracellular
polyamines in other pathologies such as
psoriasis,
muscular dystrophy, and
cystic fibrosis also accurately reflect the disease activity and, in those cases studied, response to
therapy. Therefore, the determination of
polyamine concentrations in extracellular fluids and in erythrocytes allows for (1) the early assessment of response to multimodality
therapy, (2) disease or
tumor staging, and (3) assessment of disease activity including long-term monitoring of
polyamine concentrations to pinpoint remission and relapse in adjuvant patients. Information obtained by the monitoring of
polyamines could result in prolongation of survival time of patients as well as assist in the design of the most effective
therapy regimen for the pathology. Since other such specific kinetic markers are not available,
polyamines should be clinically utilized to track
tumor evolution and
tumor response to
therapy in those patients at high risk, in which such measurements could be translated into therapeutic efficacy.