Elevated Serum Vitamin B12 Levels and Functional Vitamin B12 Deficiency among Patients with Myeloproliferative Neoplasms.

IF 0.6 4区医学 Q4 HEMATOLOGY

Indian Journal of Hematology and Blood Transfusion Pub Date : 2025-07-01 Epub Date: 2024-09-25 DOI:10.1007/s12288-024-01877-w

Murugesan Harini, Kolar Vishwanath Vinod, Prashant S Adole, Biswajit Dubashi

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引用次数: 0

Abstract

Background: Despite elevated serum vitamin B12 levels, functional (i.e., metabolically manifest) vitamin B12 deficiency has been reported in a significant proportion of MPN patients. This study aimed to assess the prevalence of functional vitamin B12 deficiency and elevated serum vitamin B12 levels among Indian MPN patients.

Methods: This cross-sectional study evaluated serum vitamin B12, homocysteine, methyl malonic acid (MMA) and holotranscobalamin levels among 176 MPN patients. Serum vitamin B12 levels between 150 and 950 pg/mL were considered normal. Functional vitamin B12 deficiency was diagnosed based on combination of elevated serum MMA (> 0.4 nmol/mL) and homocysteine (> 15 µmol/L) levels and low serum holotranscobalamin levels (< 25 pmol/L), irrespective of serum vitamin B12 levels and clinical manifestations of deficiency.

Results: Among patients enrolled (n = 176), 108 (61%) had chronic phase CML, 37 (21%) PV, 23 (13%) PMF and 8 (4%) ET. Nearly one-third were newly diagnosed to have MPNs and treatment naïve. Elevated serum vitamin B12 levels (> 950pg/mL) were seen in about a quarter (n = 45) of MPN patients. Half (n = 89) were detected to have functional vitamin B12 deficiency. No association was found between functional vitamin B12 deficiency and serum vitamin B12 levels and functional deficiency prevalence did not differ significantly between different types of MPNs and between newly diagnosed (treatment-naïve) and already treated MPNs.

Conclusion: About a quarter of MPN patients had elevated serum B12 levels and half had functional vitamin B12 deficiency. Functional deficiency was diagnosed independent of serum vitamin B12 levels. Hence, evaluation for functional deficiency should be carried out irrespective of serum vitamin B12 levels. Future studies should evaluate potential benefit of vitamin B12 replacement in MPN patients with functional vitamin B12 deficiency.

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骨髓增殖性肿瘤患者血清维生素B12水平升高和功能性维生素B12缺乏

背景：尽管血清维生素B12水平升高，功能性（即代谢表现）维生素B12缺乏症在相当大比例的MPN患者中已被报道。本研究旨在评估印度MPN患者中功能性维生素B12缺乏症和血清维生素B12水平升高的患病率。方法：本横断面研究评估176例MPN患者血清维生素B12、同型半胱氨酸、甲基丙二酸（MMA）和全反钴胺素水平。血清维生素B12水平在150 - 950 pg/mL之间被认为是正常的。根据血清MMA （> 0.4 nmol/mL）和同型半胱氨酸（> 15µmol/L）水平升高以及血清全反钴胺素水平低，诊断为功能性维生素B12缺乏症(结果：在纳入的患者中（n = 176）， 108例（61%）为慢性CML， 37例（21%）PV， 23例（13%）PMF和8例（4%）ET。近三分之一的新诊断为mpn并接受naïve治疗。大约四分之一（n = 45）的MPN患者血清维生素B12水平升高（bb0 950pg/mL）。一半（n = 89）被检测为功能性维生素B12缺乏症。功能性维生素B12缺乏和血清维生素B12水平之间没有关联，不同类型的mpn之间以及新诊断的mpn （treatment-naïve）和已经治疗的mpn之间，功能性缺乏的患病率没有显著差异。结论：约四分之一的MPN患者血清B12水平升高，一半患者有功能性维生素B12缺乏症。功能性缺陷的诊断与血清维生素B12水平无关。因此，无论血清维生素B12水平如何，功能性缺陷的评估都应该进行。未来的研究应评估维生素B12替代对功能性维生素B12缺乏症的MPN患者的潜在益处。

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来源期刊

Indian Journal of Hematology and Blood Transfusion HEMATOLOGY-

CiteScore

1.70

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Indian Journal of Hematology and Blood Transfusion is a medium for propagating and exchanging ideas within the medical community. It publishes peer-reviewed articles on a variety of aspects of clinical hematology, laboratory hematology and hemato-oncology. The journal exists to encourage scientific investigation in the study of blood in health and in disease; to promote and foster the exchange and diffusion of knowledge relating to blood and blood-forming tissues; and to provide a forum for discussion of hematological subjects on a national scale. The Journal is the official publication of The Indian Society of Hematology & Blood Transfusion.