The 8-hydroxy-2'-deoxyguanosine (8-OHdG), presently the most popular marker for oxidative DNA damage, level has been reported to be elevated in patients with various malignancies. In the present study, urinary 8-OHdG was examined in 44 patients with hematological disorders (13 malignant lymphoma, 11 adult T cell leukemia/lymphoma (ATL), 10 acute leukemia, and 10 myelodysplastic syndrome (MDS)) by an enzyme-linked immunosorbent assay. The pre-therapy level of urinary 8-OHdG in ATL patients was significantly elevated compared with normal controls (25.3 +/- 12.9 vs. 11.9 +/- 7.3 ng/mg, P < 0.05). Although patients with lymphoma, acute leukemia and MDS also showed higher urinary 8-OHdG levels than normal controls, the differences were not significant. However, two patients with refractory anemia with excess blasts in transformation (RAEB-t) having extreme monocytosis and neutrophilia showed exceptionally high urinary 8-OHdG levels (161.0 and 218.9 ng/mg). Urinary 8-OHdG excretion increased transiently with chemotherapy, and this fluctuation was significant irrespective of the disorder (P < 0.05). Interestingly, lymphoma patients with high LDH, advanced stage, poor performance status or International Prognostic Index (IPI) of high/high-intermediate risk had significantly elevated urinary 8-OHdG levels (P < 0.05- < 0.001). These latter results suggest that urinary 8-OHdG may be a reliable prognostic marker in lymphoma patients and should encourage large scale and long term follow up studies. (C) 2000 Elsevier Science Ltd. All rights reserved.