Ahmet ÜNLÜ, Başak ÜNVER KOLUMAN, Sibel HACIOĞLU, Gülsüm AKGÜN ÇAĞLIYAN, Nil GÜLER

Akut lösemilerde serum vitamin B12 yüksekliğinin prediktif değeri

Amaç: Bu çalışmada; tanı anında bakılan yüksek vitamin B12 düzeylerinin akut lösemilerde prediktif bir faktör olup olmadığını belirlemeyi amaçladık.Gereç ve yöntem: Çalışmamız akut lösemi (AML ve ya ALL) tanısı alan 95 hastanın anamnez ve laboratuvar bilgileri retrospektif olarak değerlendirilerek hazırlanmıştır. Anamnez ve laboratuvar bilgileri taranarak B12 vitamini düzeyini yükselttiği açıkça bilinen durumlardan herhangi birine sahip olanlar çalışmaya dahil edilmemiştir.Bulgular: Toplamda hastaların %36'sında tanı anındaki serum vitamin B12 düzeyinin normal referans aralığının (>771ng/L) üzerinde olduğu görüldü. Yüksek serum vitamin B12 düzeyinin prognoza etkisini değerlendirmek için yapılan sağ kalım analizinde istatistiksel olarak anlamlı bir fark gözlenmedi.Sonuç: Bu çalışmadan elde ettiğimiz veriler; yüksek serum vitamin B12 düzeylerinin akut lösemi için öngörü değeri olabileceğini göstermektedir.

Anahtar Kelimeler:

vitamin B12, Akut lösemi, kanser, kobalamin

Predictive value of serum vitamin B12 elevation in acute leukemia

Purpose: In this study; we sought to assess whether elevated vitamin B12 levels during the course of diagnosis might be a predictor of acute leukemias.Materials and method: The study was prepared by retrospectively evaluating the anamnesis and laboratory information of 95 patients diagnosed with acute leukemia (AML or ALL). Those who had any of the conditions clearly known to increase vitamin B12 levels by scanning their anamnesis and laboratory information were not included in the study.Results: In total, it was observed that serum vitamin B12 level at the time of diagnosis was above the normal reference range (>771ng/L) in 36% of the patients. In the survival analysis performed to evaluate the effect of high serum vitamin B12 levels on prognosis, no statistically significant difference was found.Conclusion: The data we obtained from this study; shows that high serum vitamin B12 levels may have predictive value for acute leukemia.

Keywords:

Acute leukemia, cancer, cobalamin, vitamin B12,

PDF

___

1. National Cancer İnstitute's Surveillance Epidemiology and End Results (SEER) Program. Cancer stat facts: Leukemia-Acute Lymphocytic Leukemia (ALL). Available at: https://seer.cancer.gov/statfacts/html/alyl.html. Accessed 20 February 2022
2. National Cancer İnstitute's Surveillance Epidemiology and End Results (SEER) Program. Cancer stat facts: Leukemia-Acute Myeloid Leukemia (AML). Available at: https://seer.cancer.gov/statfacts/html/amyl.html. Accessed 20 February 2022
3. Zulfiqar AA, Emmanuel A. Hypervitaminemia B12: a biological marker yet to be known. Mini review. Palliat Med Care Int J 2018;1:555553. https://doi.org/10.19080/PMCIJ.2018.01.555553
4. Andrès E, Serraj K, Zhu J, Vermorken AJM. The pathophysiology of elevated vitamin B12 in clinical practice. QJM 2013;106:505-515. https://doi.org/10.1093/qjmed/hct051
5. Arendt JF, Nexo E. Unexpected high plasma cobalamin: proposal for a diagnostic strategy. Clin Chem Lab Med 2013;51:489-496. https://doi.org/10.1515/cclm-2012-0545
6. Arendt JF, Pedersen L, Nexo E, Sorensen HT. Elevated plasma vitamin B12 levels as a marker for cancer: a population-based cohort study. J Natl Cancer Inst 2013;105:1799-1805. https://doi.org/10.1093/jnci/djt315
7. Arendt JF, Nexo E. Cobalamin related parameters and disease patterns in patients with increased serum cobalamin levels. PLoS One 2012;7:e45979. https://doi.org/10.1371/journal.pone.0045979
8. Chiche L, Jean R, Romain F, et al. Clinical Implications of high cobalamin blood levels for internal medicine. Rev Med Interne 2008;29:187-194. https://doi.org/10.1016/j.revmed.2007.07.007
9. Gauchan D, Joshi N, Gill AS, et al. Does an elevated serum vitamin B12 level mask actual vitamin B12 deficiency in myeloproliferative disorders? Clin Lymphoma Myeloma Leuk 2012;12:269-273. https://doi.org/10.1016/j.clml.2012.01.008
10. Gimsing P, Petersen CO, Hippe E. Cobalamin and cobalamin-binding proteins in plasma related to the clinical condition in chronic myelogenous leukemia. Leukemia 1995;9:1604-1609. https://doi.org/10.1515/cclm-2012-0545
11. Overview of alcohol consumption: drinking levels defined. national institute on alcohol abuse and alcoholism. Available at: https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking. Accessed 01 June 2022
12. Zheng Y, Li Y, Satija A, et al. Association of changes in red meat consumption with total and cause specific mortality among US women and men: two prospective cohort studies. BMJ 2019;365:l2110. https://doi.org/10.1136/bmj.l2110
13. Arendt JF, Sorensen HT, Horsfall LJ, Petersen I. Elevated vitamin B12 levels and cancer risk in uk primary care: a thin database cohort study. Cancer Epidemiol Biomarkers Prev 2019;28:814-821. https://doi.org/10.1158/1055-9965.EPI-17-1136
14. Gavars D, Perminov D, Tauckels E, Lindenberga I, Auce A, Lejniece S. Association of elevated vitamin B12 with oncohematological diseases in a cohort of 79,524 patients from latvia. Experimental Oncol 2019;41:357-362. https://doi.org/10.32471/exp-oncology.2312-8852.vol-41-no-4.13930
15. Ryg J, Nybo M, Hallas J. Cancer ıncidence in persons with elevated cobalamin levels. Comparative study. Eur J Clin Invest 2013;43:557-561. https://doi.org/10.1111/eci.12076
16. Arendt JF, Farkas DK, Pedersen L, Nexo E, Sørensen HT. Elevated plasma vitamin B12 levels and cancer prognosis: a population-based cohort study. Cancer Epidemiol 2016;40:158-165. https://doi.org/10.1016/j.canep.2015.12.007
17. Oh HK, Lee JY, Eo WK, Yoon SW, Han SN. Elevated serum vitamin B12 levels as a prognostic factor for survival time in metastatic cancer patients: a retrospective study, nutrition and cancer. 2018;70:37-44. https://doi.org/10.1080/01635581.2018.1397711
18. Lin CY, Kuo CS, Lu CL, Wu MY, Huang RF. Elevated serum vitamin B12 levels in association with tumor markers as the prognostic factors predictive for poor survival in patients with hepatocellular carcinoma. Nutr Cancer 2010;62:190-197. https://doi.org/10.1080/01635580903305334
19. Zulfiqar AA, Sebaux A, Dramé M, Andres E. Hypervitaminemia B12 and malignant diseases: report of a cross-sectional study in an acute geriatric unit. Ann Biol Clin (Paris) 2017;75:193-203. https://doi.org/10.1684/abc.2017.1227