Issue: 2003 > August > original article

Low cobalamin (vitamin B<i>12</i>) levels in multiple myeloma: a retrospective study

L.Th. Vlasveld


Background: In patients with multiple myeloma a variety
of metabolic events may occur. One of these are changes in the serum cobalamin (vitamin B12) concentration. Elevated as well as decreased serum cobalamin levels have been reported. The prevalence and clinical consequences of low cobalamin levels are largely unknown.
Objective: To investigate the prevalence of low serum
cobalamin levels in patients with multiple myeloma and
to describe the clinical features, haematological parameters and outcome in patients with multiple myeloma with low and normal serum cobalamin levels.
Methods: A retrospective study was conducted in the
Deaconess Hospital in Eindhoven. Thirty-two patients
were identified who fulfilled the diagnostic criteria for
multiple myeloma and had at least one serum cobalamin
level tested during the diagnostic or treatment period.
A number of clinical characteristics, haematological
parameters and outcome were scored.
Results: Twenty-one (66%) patients had a normal serum
cobalamin level, nine (28%) patients had a low one and
two (6%) patients had an elevated serum cobalamin
level. Between the group with a normal and a low serum
cobalamin level there were no differences in patients
characteristics such as sex and age, tumour characteristics such as the type of paraprotein, tumour load or tumour stage nor in haematological parameters such as haemoglobin level, mean corpuscular volume and megaloblastic changes in the bone marrow. The median survival was not statistically different between both groups.