Fadul Abdalla, Abdalla Elmustafa, Mohamed Anas, Ali Bashir, Elamin Nusiba, Alsayed Ahmed Abdelghafar, Al-Mashdali Abdulrahman F, Singh Kalpana, Mohamed Shehab F
Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Department of Hematology, Hamad Medical Corporation, Doha, Qatar.
J Blood Med. 2024 Dec 27;15:549-556. doi: 10.2147/JBM.S474393. eCollection 2024.
Elevated vitamin B12 (B12) levels are linked to an increased risk of cancers, including hematological malignancies. This study focuses on the relationship between elevated B12 and myeloproliferative neoplasms (MPNs): Polycythemia Vera (PV), Primary Myelofibrosis (MF), Essential Thrombocytosis (ET), and Chronic Myeloid Leukemia (CML). Elevated B12 in MPNs is believed to arise from increased transcobalamin I (TCI) secretion by proliferating leukocytes, leading to higher serum levels. B12 may serve as a diagnostic and prognostic biomarker for these conditions. However, its sensitivity, specificity, and cutoff levels are unclear.
To assess the prevalence of high B12 levels in MPN patients, determine the median levels, identify a diagnostic cutoff, and evaluate the sensitivity and specificity of B12 as a marker.
Data were retrieved from the National Center for Cancer Care and Research in Doha, Qatar, for MPN patients from January 2016 to December 2022.
A total of 467 patients were included: 232 with CML, 98 with PV, 88 with ET, and 50 with MF. The majority were male (66%) and of Asian origin (56%), with a median age of 48.7 years. CBC results showed median hemoglobin of 9.2 g/dL, WBC count of 73 x 10^3/uL, and platelet count of 531 x 10^3/uL. Elevated B12 levels were found in 95 patients (20%): 71% CML, 14% PV, 10% MF, and 5% ET. Extreme elevations were seen in 59 patients. The mean B12 level decreased from 747.3 ± 686.5 pg/mL before treatment to 397.9 ± 343.7 pg/mL after one year (p=0.01). Median levels were 458 pg/mL (718) before treatment and 301 pg/mL (229) after. In the extreme high B12 group, the mean was 1722 pg/mL before and 677 pg/mL after treatment.
Elevated B12 levels are associated with disease activity in CML. However, their role as a reliable marker for disease monitoring remains uncertain, and further studies are needed to confirm their utility for CML progression.
维生素B12（B12）水平升高与包括血液系统恶性肿瘤在内的癌症风险增加有关。本研究聚焦于B12水平升高与骨髓增殖性肿瘤（MPN）之间的关系，MPN包括真性红细胞增多症（PV）、原发性骨髓纤维化（MF）、原发性血小板增多症（ET）和慢性髓性白血病（CML）。MPN中B12水平升高被认为是由于增殖的白细胞分泌转钴胺素I（TCI）增加，导致血清水平升高。B12可能作为这些疾病的诊断和预后生物标志物。然而，其敏感性、特异性和临界值尚不清楚。
评估MPN患者中高B12水平的患病率，确定中位数水平，确定诊断临界值，并评估B12作为标志物的敏感性和特异性。
从卡塔尔多哈国家癌症护理与研究中心检索2016年1月至2022年12月期间MPN患者的数据。
共纳入467例患者，其中CML患者232例，PV患者98例，ET患者88例，MF患者50例。大多数患者为男性（66%），亚洲裔（56%），中位年龄48.7岁。全血细胞计数结果显示，血红蛋白中位数为9.2g/dL，白细胞计数为73×10³/μL，血小板计数为531×10³/μL。95例患者（20%）B12水平升高，其中CML患者占71%，PV患者占14%，MF患者占10%，ET患者占5%。59例患者出现极高水平。治疗前B12平均水平为747.3±686.5pg/mL，治疗1年后降至397.9±343.7pg/mL（p=0.01）。治疗前中位数水平为458pg/mL（718），治疗后为301pg/mL（229）。在极高B12组中，治疗前平均水平为1722pg/mL，治疗后为677pg/mL。
B12水平升高与CML的疾病活动相关。然而，其作为疾病监测可靠标志物的作用仍不确定，需要进一步研究来证实其在CML进展中的效用。
