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Prevalence of vitamin B12 deficiency in patients with plasma cell dyscrasias
Author(s) -
Baz Rachid,
Alemany Carlos,
Green Ralph,
Hussein Mohamad A.
Publication year - 2004
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.20441
Subject(s) - medicine , vitamin b12 , mean corpuscular volume , dyscrasia , methylmalonic acid , anemia , megaloblastic anemia , multiple myeloma , univariate analysis , gastroenterology , plasma cell , multivariate analysis , hematocrit
BACKGROUND To the authors' knowledge, the prevalence of vitamin B12 deficiency among patients with plasma cell dyscrasias (PCD) is largely unknown. Identifying this vitamin deficiency in such patients could help improve their anemia and increase their tolerance to potentially neurotoxic agents. METHODS The authors retrospectively reviewed the charts and laboratory results of 664 consecutive patients diagnosed with PCD who had their vitamin B12 and folate status evaluated between 1997 and 2001 at the Cleveland Clinic Multiple Myeloma Research Program. The patients were screened for vitamin B12 deficiency using serum vitamin B12 and methylmalonic acid. RESULTS Of the 664 patients whose medical charts were reviewed, information on vitamin B12 status was available for 522 patients (78%). Among these 522 patients, 71 (13.6%) had laboratory‐defined vitamin B12 deficiency and the remaining 451 patients (86.4%) did not. On univariate analysis, vitamin B12 deficiency correlated with immunoglobulin A (IgA) PCD ( P = 0.04), higher mean corpuscular volume ( P = 0.008), and longer follow‐up ( P = 0.048). In a covariate adjusted model, only the presence of IgA PCD was associated with an increased prevalence of vitamin B12 deficiency ( P = 0.003). CONCLUSIONS Vitamin B12 deficiency was prevalent in patients with PCD, especially in patients with the IgA subtype. Serum vitamin B12 measurements should be part of the initial evaluation and subsequent workups for anemia in patients with PCD. Cancer 2004. © 2004 American Cancer Society.