Multiple myeloma associated with biochemical evidence of vitamin bu deficiency

Ralph Green, Michael J. Beckmann, Donald W. Jacobsen, Mohamad A. Hussein

Research output: Contribution to journalArticle

Abstract

Unexplained low serum vitamin B|2 (Br) concentrations have been reported in multiple myeloma (MM), with or without associated clinical manifestations of B r deficiency. Raised serum levels of methylmalonic acid (MMA) are a sensitive and specific marker for biochemical B|; deficiency in the absence of significant renal impairment. We defined biochemical evidence of presumed Bp deficiency as a finding of serum MMA above the normal reference range (mean ±3SD) with or without raised total homocysteine (tHCY) in the absence of significant renal disease (creatinine <2.0 mg/dl). Five of 42 patients with MM had serum Br below normal (<170 pg/ml). Three of these had raised MMA and tHCY; one had raised MMA alone. None had serum creatinine >2.0 mg/dl. In a further six patients with normal serum Bp, two had raised MMA and tHCY and four had raised MMA alone. All had serum creatinine <2.0 mg/dl. The occurrence of presumed B |2 deficiency observed in a high proportion of our patients with MM (11 of 42 or 26% with raised metabolites not explained by significant renal impairment) may be the result of increased B]2 requirements in this condition. Increased uptake and accumulation of Bp has been reported in myeloma cells in culture (Ermens A. et al. Eur.J.Haematol 50:57,1993). B|2 administration to patients with MM may accelerate tumor growth (Schleinitz N, et al. Leuk.Res. 22:287, 1998) and supplements of this vitamin may, therefore, be contraindicated in patients with clonal plasma cell dyscrasias. It is possible that analogues or inhibitors of Bp may prove useful in the management of MM.

Original languageEnglish (US)
JournalBlood
Volume96
Issue number11 PART II
StatePublished - 2000

Fingerprint

Methylmalonic Acid
Avitaminosis
Multiple Myeloma
Vitamins
Homocysteine
Serum
Creatinine
Kidney
Reference Values
Riboflavin
Metabolites
Paraproteinemias
Tumors
Plasmas
Cell Culture Techniques
Biomarkers
Growth
Neoplasms

ASJC Scopus subject areas

  • Hematology

Cite this

Green, R., Beckmann, M. J., Jacobsen, D. W., & Hussein, M. A. (2000). Multiple myeloma associated with biochemical evidence of vitamin bu deficiency. Blood, 96(11 PART II).

Multiple myeloma associated with biochemical evidence of vitamin bu deficiency. / Green, Ralph; Beckmann, Michael J.; Jacobsen, Donald W.; Hussein, Mohamad A.

In: Blood, Vol. 96, No. 11 PART II, 2000.

Research output: Contribution to journalArticle

Green, R, Beckmann, MJ, Jacobsen, DW & Hussein, MA 2000, 'Multiple myeloma associated with biochemical evidence of vitamin bu deficiency', Blood, vol. 96, no. 11 PART II.
Green R, Beckmann MJ, Jacobsen DW, Hussein MA. Multiple myeloma associated with biochemical evidence of vitamin bu deficiency. Blood. 2000;96(11 PART II).
Green, Ralph ; Beckmann, Michael J. ; Jacobsen, Donald W. ; Hussein, Mohamad A. / Multiple myeloma associated with biochemical evidence of vitamin bu deficiency. In: Blood. 2000 ; Vol. 96, No. 11 PART II.
@article{58b22097a6834cab995f79082ac2ef48,
title = "Multiple myeloma associated with biochemical evidence of vitamin bu deficiency",
abstract = "Unexplained low serum vitamin B|2 (Br) concentrations have been reported in multiple myeloma (MM), with or without associated clinical manifestations of B r deficiency. Raised serum levels of methylmalonic acid (MMA) are a sensitive and specific marker for biochemical B|; deficiency in the absence of significant renal impairment. We defined biochemical evidence of presumed Bp deficiency as a finding of serum MMA above the normal reference range (mean ±3SD) with or without raised total homocysteine (tHCY) in the absence of significant renal disease (creatinine <2.0 mg/dl). Five of 42 patients with MM had serum Br below normal (<170 pg/ml). Three of these had raised MMA and tHCY; one had raised MMA alone. None had serum creatinine >2.0 mg/dl. In a further six patients with normal serum Bp, two had raised MMA and tHCY and four had raised MMA alone. All had serum creatinine <2.0 mg/dl. The occurrence of presumed B |2 deficiency observed in a high proportion of our patients with MM (11 of 42 or 26{\%} with raised metabolites not explained by significant renal impairment) may be the result of increased B]2 requirements in this condition. Increased uptake and accumulation of Bp has been reported in myeloma cells in culture (Ermens A. et al. Eur.J.Haematol 50:57,1993). B|2 administration to patients with MM may accelerate tumor growth (Schleinitz N, et al. Leuk.Res. 22:287, 1998) and supplements of this vitamin may, therefore, be contraindicated in patients with clonal plasma cell dyscrasias. It is possible that analogues or inhibitors of Bp may prove useful in the management of MM.",
author = "Ralph Green and Beckmann, {Michael J.} and Jacobsen, {Donald W.} and Hussein, {Mohamad A.}",
year = "2000",
language = "English (US)",
volume = "96",
journal = "Blood",
issn = "0006-4971",
publisher = "American Society of Hematology",
number = "11 PART II",

}

TY - JOUR

T1 - Multiple myeloma associated with biochemical evidence of vitamin bu deficiency

AU - Green, Ralph

AU - Beckmann, Michael J.

AU - Jacobsen, Donald W.

AU - Hussein, Mohamad A.

PY - 2000

Y1 - 2000

N2 - Unexplained low serum vitamin B|2 (Br) concentrations have been reported in multiple myeloma (MM), with or without associated clinical manifestations of B r deficiency. Raised serum levels of methylmalonic acid (MMA) are a sensitive and specific marker for biochemical B|; deficiency in the absence of significant renal impairment. We defined biochemical evidence of presumed Bp deficiency as a finding of serum MMA above the normal reference range (mean ±3SD) with or without raised total homocysteine (tHCY) in the absence of significant renal disease (creatinine <2.0 mg/dl). Five of 42 patients with MM had serum Br below normal (<170 pg/ml). Three of these had raised MMA and tHCY; one had raised MMA alone. None had serum creatinine >2.0 mg/dl. In a further six patients with normal serum Bp, two had raised MMA and tHCY and four had raised MMA alone. All had serum creatinine <2.0 mg/dl. The occurrence of presumed B |2 deficiency observed in a high proportion of our patients with MM (11 of 42 or 26% with raised metabolites not explained by significant renal impairment) may be the result of increased B]2 requirements in this condition. Increased uptake and accumulation of Bp has been reported in myeloma cells in culture (Ermens A. et al. Eur.J.Haematol 50:57,1993). B|2 administration to patients with MM may accelerate tumor growth (Schleinitz N, et al. Leuk.Res. 22:287, 1998) and supplements of this vitamin may, therefore, be contraindicated in patients with clonal plasma cell dyscrasias. It is possible that analogues or inhibitors of Bp may prove useful in the management of MM.

AB - Unexplained low serum vitamin B|2 (Br) concentrations have been reported in multiple myeloma (MM), with or without associated clinical manifestations of B r deficiency. Raised serum levels of methylmalonic acid (MMA) are a sensitive and specific marker for biochemical B|; deficiency in the absence of significant renal impairment. We defined biochemical evidence of presumed Bp deficiency as a finding of serum MMA above the normal reference range (mean ±3SD) with or without raised total homocysteine (tHCY) in the absence of significant renal disease (creatinine <2.0 mg/dl). Five of 42 patients with MM had serum Br below normal (<170 pg/ml). Three of these had raised MMA and tHCY; one had raised MMA alone. None had serum creatinine >2.0 mg/dl. In a further six patients with normal serum Bp, two had raised MMA and tHCY and four had raised MMA alone. All had serum creatinine <2.0 mg/dl. The occurrence of presumed B |2 deficiency observed in a high proportion of our patients with MM (11 of 42 or 26% with raised metabolites not explained by significant renal impairment) may be the result of increased B]2 requirements in this condition. Increased uptake and accumulation of Bp has been reported in myeloma cells in culture (Ermens A. et al. Eur.J.Haematol 50:57,1993). B|2 administration to patients with MM may accelerate tumor growth (Schleinitz N, et al. Leuk.Res. 22:287, 1998) and supplements of this vitamin may, therefore, be contraindicated in patients with clonal plasma cell dyscrasias. It is possible that analogues or inhibitors of Bp may prove useful in the management of MM.

UR - http://www.scopus.com/inward/record.url?scp=33748577965&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33748577965&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:33748577965

VL - 96

JO - Blood

JF - Blood

SN - 0006-4971

IS - 11 PART II

ER -