Assessment Of Serum Cyanocobalamin Level And Importance In Patients With Hematological Malignancies

Yıl 2023, Cilt: 14 Sayı: 2, 270 - 273, 30.06.2023

Esra Zeynelgil , Buğra Sağlam , Mehmet Asıl , Özlem Doğan

https://doi.org/10.18663/tjcl.1225685

Öz

ABSTRACT
Aim: In our study, we planned to investigate the effect of serum cyanocobalamin (Vitamin B12) levels at the time of diagnosis in patients with various hematological malignancies.
Patients and Methods: Two hundred and one patients between 18-75 years old diagnosed with various hematological malignancies and 30 healthy controls applying to outpatient and inpatient clinics of Hematology Department in Necmettin Erbakan University Meram Faculty of Medicine between 2010-2014 years were included in the study. Demographic and clinical data and laboratory findings of the patients included in the study were recorded retrospectively.
Results: A total of 231 patients, 132 men (57.1%) and 99 women (42.9%), were included in our study, of which 201 were patients and 30 were healthy controls. The mean serum vitamin B12 concentration of all patients was found as 344.9 ± 279.0 pg/mL. When vitamin B12 levels were analyzed according to diagnostic groups, it was found to be highest in CML (596.0 ± 428.3 pg / mL) and ALL (524.5 ± 442.6 pg / mL) patients and lowest in AML patients (240.9 ± 178, 0 pg / mL); the difference was statistically significant (p <0.001). Vitamin B12 levels of diagnostic groups were found to have no significant effect on survival.
Conclusion: Cyanocobalamin levels were found to be high in patients with hematological malignancies, especially in CML patients. A high level of cyanocobalamin may be helpful in prediction of CML, however prospective studies are required to support this finding.

Anahtar Kelimeler

cyanocobalamin, CML, ALL, AML, Vitamin B12

Hematolojik malignitesi olan hastalarda serum siyanokobalamin düzeyi ve öneminin değerlendirilmesi

Öz

Amaç: Çalışmamızda farklı hematolojik maligniteleri olan hasta gruplarında tanı anındaki serum siyanokobalamin (Vitamin B12) düzeylerinin tanıları ön görmede etkisini araştırmayı planladık..
Gereç ve Yöntemler: Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Hematoloji poliklinik ve kliniğine 2010-2014 yılları arasında başvurmuş olan 18-75 yaş arası hematolojik malignite tanısı almış olan 201 hasta ve 30 sağlıklı kontrol grubu çalışma kapsamına alındı. Çalışma kapsamına dahil edilen hastaların demografik, klinik ve laboratuar verileri retrospektif olarak kayıt altına alınmıştır.
Bulgular: Çalışmamıza 132’si erkek (%57,1) ve 99’u kadın (%42,9) olmak üzere toplam 201 hasta ve 30 sağlıklı kontrol grubu olmak üzere 231 kişi dahil edildi. Tüm hastaların ortalama serum Vitamin B12 konsantrasyonu 344,9±279,0 pg/mL olarak gözlendi. Tanı gruplarına göre Vitamin B12 düzeylerinin değerlendirmesinde ise; KML (596,0±428,3 pg/mL) ve ALL (524,5±442,6 pg/mL) hastalarında en yüksek, AML (240,9±178,0 pg/mL) hastalarında ise en düşük olduğu ve bu farklılığın istatistiksel olarak anlamlı olduğu gözlendi (p<0,001). Hastalık gruplarının Vitamin B12 düzeylerinin sağ kalım üzerine anlamlı fark saptanmamıştır.
Sonuç: Hematolojik malignitesi olan hastalarda ve özellikle KML hastalarında siyanokobalamin düzeyi yüksek bulunmuştur. KML hastalığının tanısı için yüksek siyanokobalamin düzeyi hastalığı ön görmede yardımcı olabilir ancak bunun prospektif çalışmalarla deseklenmesi gerekmektedir.
Anahtar Kelimeler: siyanokobalamin, KML, ALL,AML, Vitamin B12

Anahtar Kelimeler

cyanocobalamin, CML, ALL, AML, Vitamin B12

Kaynakça

• 1. Robscheit-Robbins, F.S. and G.H. Whipple, Blood Regeneration in Severe Anemia : Xiv. A Liver Fraction Potent in Pernicious Anemia Fed Alone and Combined with Whole Liver, Liver Ash and Fresh Bile. J Exp Med, 1929. 49(2): p. 215-27.
• 2. Arendt, J.F. and E. Nexo, Cobalamin related parameters and disease patterns in patients with increased serum cobalamin levels. PLoS One, 2012. 7(9): p. e45979.
• 3. Chiche, L., et al., [Clinical implications of high cobalamin blood levels for internal medicine]. Rev Med Interne, 2008. 29(3): p. 187-94.
• 4. Lildballe, D.L., et al., Haptocorrin as marker of disease progression in fibrolamellar hepatocellular carcinoma. European Journal of Surgical Oncology (EJSO), 2011. 37(1): p. 72-79.
• 5. Nörredam, K., et al., Plasma cobalamin and transcobalamin in patients with primary carcinoma of the liver: A study from Thailand. Scandinavian journal of gastroenterology, 1983. 18(2): p. 229-232.
• 6. Carmel, R. and L. Eisenberg, Serum vitamin B12 and transcobalamin abnormalities in patients with cancer. Cancer, 1977. 40(3): p. 1348-1353.
• 7. Wakatsuki, Y., et al., Immunological characterization and clinical implication of cobalamin binding protein in human gastric cancer. Cancer research, 1989. 49(11): p. 3122-3128.
• 8. Gimsing, P., C. Overballe-Petersen, and E. Hippe, Cobalamin and cobalamin-binding proteins in plasma related to the clinical condition in chronic myelogenous leukemia. Leukemia, 1995. 9(9): p. 1604.
• 9. Zittoun, J., et al., The three transcobalamins in myeloproliferative disorders and acute leukaemia. British journal of haematology, 1975. 31(3): p. 287-298.
• 10. Manzanares, W. and G. Hardy, Vitamin B12: the forgotten micronutrient for critical care. Curr Opin Clin Nutr Metab Care, 2010. 13(6): p. 662-8.
• 11. Herrmann, W., et al., Vitamin B-12 status, particularly holotranscobalamin II and methylmalonic acid concentrations, and hyperhomocysteinemia in vegetarians. Am J Clin Nutr, 2003. 78(1): p. 131-6.
• 12. Lesho, E.P. and A. Hyder, Prevalence of subtle cobalamin deficiency. Arch Intern Med, 1999. 159(4): p. 407.
• 13. Ermens, A.A., L.T. Vlasveld, and J. Lindemans, Significance of elevated cobalamin (vitamin B12) levels in blood. Clin Biochem, 2003. 36(8): p. 585-90.
• 14. Salles, N., et al., High vitamin B12 level: a strong predictor of mortality in elderly inpatients. J Am Geriatr Soc, 2005. 53(5): p. 917-8.
• 15. Heinz, J., et al., B vitamins and the risk of total mortality and cardiovascular disease in end-stage renal disease: results of a randomized controlled trial. Circulation, 2010. 121(12): p. 1432-8.
• 16. Sviri, S., et al., Increased Vitamin B12 levels are associated with mortality in critically ill medical patients. Clin Nutr, 2012. 31(1): p. 53-9.
• 17. Carmel, R., Extreme elevation of serum transcobalamin I in patients with metastatic cancer. N Engl J Med, 1975. 292(6): p. 282-4.
• 18. Gimsing, P., Cobalamin metabolism in chronic myelogenous leukemia. Danish medical bulletin, 1998. 45(5): p. 459-479.
• 19. Gimsing, P., Cobalamin forms and analogues in plasma and myeloid cells during chronic myelogenous leukaemia related to clinical condition. British journal of haematology, 1995. 89(4): p. 812-819.
• 20. Andres, E., et al., The pathophysiology of elevated vitamin B12 in clinical practice. QJM, 2013. 106(6): p. 505-15.
• 21. Carmel, R., B. Tatsis, and L. Baril, Circulating antibody to transcobalamin II causing retention of vitamin B12 in the blood. Blood, 1977. 49(6): p. 987-1000.
• 22. Reynolds, E.H., et al., Subacute combined degeneration with high serum vitamin B12 level and abnormal vitamin B12 binding protein. New cause of an old syndrome. Arch Neurol, 1993. 50(7): p. 739-42.