Yıl: 2021 Cilt: 37 Sayı: 1 Sayfa Aralığı: 11 - 16 Metin Dili: Türkçe DOI: 10.30733/std.2020.01472 İndeks Tarihi: 04-06-2021

B12 Vitamini Düzeyinin Multiple Miyelom Kliniğine Etkisi

Öz:
Amaç: Çalışmamız multipl miyelom (MM) hastalarında, tanıda bakılan serum B12 vitamini düzeyi ile klinikve laboratuvar bulguların karşılaştırılmasını amaçlamaktadır .Hastalar ve Yöntem: 2010-2020 yılları arasında MM tanısı alan hastalar değerlendirildi. Hastalar vitaminB12 düzeylerine göre düşük ve normal olmak üzere iki gruba ayrıldı. Veriler dağılım özelliklerine görebağımsız örneklem T, Mann Whitney U ve ki-kare testleri ile karşılaştırıldı.Bulgular: Retrospektif dosya incelemesi yapılan 212 hastadan çalışmaya dahil edilen 128 hastanın 41(%32)’inde vitamin B12 eksikliği tespit edildi. Kemik iliği plazma oranı bu grupta anlamlı olarak daha düşükbulundu; medyan %30’a karşın %50 (p: 0,024). İki grup arasında yaş, total protein, laktat dehidrogenaz,ß2-mikroglobulin, kalsiyum, kreatinin, albumin ve litik lezyon varlığı açısından fark saptanmadı. Ancak vitB12 düzeyi düşük olan grupta 11 hastada (%26,8), normal olan grupta ise 44 hastada (%50,5) anemi tespitedildi. Normal olan grupta anemi sıklığının yüksekliği istatiksel olarak anlamlı bulundu (p: 0,019). AyrıcaISS ve R-ISS evreleri arasında da vitamin B12 düzeyleri açısınd an fark saptanmadı.Sonuç: Düşük vitamin B12 düzeyinde kemik iliği plazma hücre oranı daha düşük bulunmaktadır. Verilerimizile bunun klinik yansıması gösterilememiştir. Tedavi yanıtı, sağ kalım ve relaps oranları gibi klinik verilerindeğerlendirildiği çalışmalara ihtiyaç duyulmaktadır .
Anahtar Kelime:

Effect of Vitamin B12 Level on Multiple Myeloma Clinic

Öz:
Aim: The aim of our study is evaluate the association between serum vitB12 levels at time of diagnosis and clinical and laboratory signs in multiple (MM) myeloma pati ents Patients and Methods: Patienst diagnosed MM between 2010-2020 were evaluated. Patients were divided into two groups; those had low and normal levels of vitB12. Groups were analized by using independent simple T, Mann Whitney U and chi-square tests considering by distrubiti on characteristics of data. Results: Two hundred-and-twelve patients' records were examined retrospectively. Forty-one (32%) patients had low vitB12 levels. In patients with low vit B12 levels, bone marrow plasma cell ratios were also significantly lower than those found normal vit B12 levels (median %30 vs %50, respectively) (p: 0,024). There was no statistically significant difference between the two groups in terms of age, lytic bone lesion numbers, and serum levels of total protein, lactate dehydrogenase, ß2-microglobulin, calcium, creatinin, albumin. However, 11 patients (%26,8) in low vitB12 group had anemia, while 44 (%50,5) patients in normal vitB12 group had. So, anemia was more often in vitamin B12 normal group patients (p: 0,019). No dif ference was found in terms of myeloma ISS and R-ISS stages in t wo patient groups. Conclusions: Bone marrow median plasma cell ratio was also low in the group with low vit B12 levels. Our data could not show its clinical reflection. Further studies with larger groups are required to evaluate the response to treatment, survival and recurrence rate.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Kyle RA, Therneau TM, Rajkumar SV, et al. Incidence of multiple myeloma in Olmsted County, Minnesota: Trend over 6 decades. Cancer 2004;101(11):2667-74.
  • 2. Kyle RA, Rajkumar SV. Criteria for diagnosis, staging, risk stratification and response assessment of multiple myeloma. Leukemia 2009;23(1):3-9.
  • 3. Rajkumar SV. Multiple myeloma: 2020 update on diagnosis, risk stratification and management. Am J Hematol 2020;95:548-67.
  • 4. Goldschmidt H, Lokhorst HM, Mai EK, et al. Bortezomib before and after high-dose therapy in myeloma: Long-term results from the phase III HOVON-65/GMMG-HD4 trial. Leukemia 2018;32:383-90.
  • 5. Arendt JF, Pedersen L, Nexo E, et al. Elevated plasma vitamin B12 levels as a marker for cancer: A population-based cohort study. J Natl Cancer Inst 2013;105:1799-805.
  • 6. Arendt JF, Nexo E. Cobalamin related parameters and disease patterns in patients with increased serum cobalamin levels. PLoS One 2012;7:e45979.
  • 7. Carmel R. How I treat cobalamin (vitamin B12) deficiency? Blood 2008;112(6):2214-21.
  • 8. McShane CM, Murray LJ, Landgren O, et al. Prior autoimmune disease and risk of monoclonal gammopathy of undetermined signicance and multiple myeloma: A systematic review. Cancer Epidemiol Biomark Prev 2014;23(2):332-42.
  • 9. Braschi C, Doucette J, Chari A. Characterization of B12 deficiency in patients with plasma cell disorders. Blood 2015;126(23):5330.
  • 10. Shimanovsky A, Argote JA, Murali S, et al. Autoimmune manifestations in patients with multiple myeloma and monoclonal gammopathy of undetermined signicance. BBA Clinical 2016;6:12-8.
  • 11. Carmel R, Lau KH, Baylink DJ, et al. Cobalamin and osteoblast-specific proteins. N Engl J Med 1988;319(2):70-5.
  • 12. Tucker KL, Hannan MT, Qiao N, et al. Low plasma vitamin B12 is associated with lower BMD: The Framingham Osteoporosis Study. J Bone Miner Res 2005;20(1):152.
  • 13. Stone KL, Bauer DC, Sellmeyer D, et al. Low serum vitamin B-12 levels are associated with increased hip bone loss in older women: A prospective study. J Clin Endocrinol Metab 2004;89(3):1217.
  • 14. Kyle RA, Gertz MA, Witzig TE, et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc 2003;78(1):21.
  • 15. Angelova EA, Li S, Wang W, et al. IgM plasma cell myeloma in the era of novel therapy: A clinicopathological study of 17 cases. Hum Pathol 2019;84:321.
  • 16. Musto P, Falcone A, D’Arena G, et al. Clinical results of recombinant erythropoietin in transfusion-dependent patients with refractory multiple myeloma: Role of cytokines and monitoring of erythropoiesis. Eur J Haematol 1997;58(5):314- 9.
  • 17. Baz R, Alemany C, Green R, et al. Prevalence of vitamin B12 deficiency in patients with plasma cell dyscrasias: A retrospective review. Cancer 2004;101(4):790.
  • 18. Ali Z, Faroqı R, Khan MF, et al. Incidence of decline in vitamin B12 level into diagnosed patients of multiple myeloma. PJMHS 2017;11(4):1249-52.
  • 19. Şentürk Yıkılmaz A, Akıncı S, Silay K, et al. Vitamin B12 level have prognostic signi cance in multiple myeloma patients. Clin Oncol 2018;3:1434.
  • 20. Carmel R. Prevalence of undiagnosed pernicious anemia in the elderly. Arch Intern Med 1996;156(10):1097.
  • 21. Ermens AAM, Sonneveld P, Michiels JJ, et al. Increased uptake and accumulation of cobalamin by multiple myeloma bone marrow cells as a possible cause of low serum cobalamin. Eur J Haematol 1993;50(1):57-9.
  • 22. Arnalich F, Zamorano AF, Martinez-Hernández P, et al. Additional predictive value of serum unsaturated vitamin B12 proteins in multiple myeloma. J Med 1990;21(5):277-86.
  • 23. Quadros EV, Nakayama Y, Sequeria JM. The binding properties of the human receptor for the cellular uptake of vitamin B12. Biochem Biophys Res Comm 2005;327:1006- 10.
  • 24. Gimsing P, Overballe-Petersen CO, Hippe E. Cobalamin and cobalamin- binding proteins in plasma related to the clinical condition in chronic myelogenous leukemia. Leukemia 1995;9:1604-9.
  • 25. Cairo G, Bernuzzi F, Recalcati S. A precious metal: Iron, an essential nutrient for all cells. Genes Nutr 2006;1(1):25- 36.
  • 26. Dong C. TH17 cells in development: An updated view of their molecular identity and genetic programming. Nat Rev Immunol 2008;8(5):337-48.
  • 27. Mantovani A, Germano G, Marchesi F, et al. Cancerpromoting tumor- associated macrophages: New vistas and open questions. Eur J Immunol 2011;41(9):2522-5.
  • 28. Giuliani N, Rizzoli V. Myeloma cells and bone marrow osteoblast interactions: Role in the development of osteolytic lesions in multiple myeloma. Leuk Lymphoma 2007;48(12):2323-9.
  • 29. Chesi M, Bergsagel Lefi P. Moleculer pathogenesis of multiple myelom: Basic and clinical uptades. Int J Hematol 2013;97(3):313-23.
  • 30. Pichiorri F, Suh SS, Ladetto M, et al. MicroRNAs regulate critical genes associated with multiple myeloma pathogenesis. Proc Natl Acad Sci USA 2008;105(35):12885- 90.
APA Tekinalp A, Demircioğlu S, BİLGEN H, Dikici H, Ceneli O (2021). B12 Vitamini Düzeyinin Multiple Miyelom Kliniğine Etkisi. , 11 - 16. 10.30733/std.2020.01472
Chicago Tekinalp Atakan,Demircioğlu Sinan,BİLGEN Hakan,Dikici Hatice Zeynep,Ceneli Ozcan B12 Vitamini Düzeyinin Multiple Miyelom Kliniğine Etkisi. (2021): 11 - 16. 10.30733/std.2020.01472
MLA Tekinalp Atakan,Demircioğlu Sinan,BİLGEN Hakan,Dikici Hatice Zeynep,Ceneli Ozcan B12 Vitamini Düzeyinin Multiple Miyelom Kliniğine Etkisi. , 2021, ss.11 - 16. 10.30733/std.2020.01472
AMA Tekinalp A,Demircioğlu S,BİLGEN H,Dikici H,Ceneli O B12 Vitamini Düzeyinin Multiple Miyelom Kliniğine Etkisi. . 2021; 11 - 16. 10.30733/std.2020.01472
Vancouver Tekinalp A,Demircioğlu S,BİLGEN H,Dikici H,Ceneli O B12 Vitamini Düzeyinin Multiple Miyelom Kliniğine Etkisi. . 2021; 11 - 16. 10.30733/std.2020.01472
IEEE Tekinalp A,Demircioğlu S,BİLGEN H,Dikici H,Ceneli O "B12 Vitamini Düzeyinin Multiple Miyelom Kliniğine Etkisi." , ss.11 - 16, 2021. 10.30733/std.2020.01472
ISNAD Tekinalp, Atakan vd. "B12 Vitamini Düzeyinin Multiple Miyelom Kliniğine Etkisi". (2021), 11-16. https://doi.org/10.30733/std.2020.01472
APA Tekinalp A, Demircioğlu S, BİLGEN H, Dikici H, Ceneli O (2021). B12 Vitamini Düzeyinin Multiple Miyelom Kliniğine Etkisi. Selçuk Tıp Dergisi, 37(1), 11 - 16. 10.30733/std.2020.01472
Chicago Tekinalp Atakan,Demircioğlu Sinan,BİLGEN Hakan,Dikici Hatice Zeynep,Ceneli Ozcan B12 Vitamini Düzeyinin Multiple Miyelom Kliniğine Etkisi. Selçuk Tıp Dergisi 37, no.1 (2021): 11 - 16. 10.30733/std.2020.01472
MLA Tekinalp Atakan,Demircioğlu Sinan,BİLGEN Hakan,Dikici Hatice Zeynep,Ceneli Ozcan B12 Vitamini Düzeyinin Multiple Miyelom Kliniğine Etkisi. Selçuk Tıp Dergisi, vol.37, no.1, 2021, ss.11 - 16. 10.30733/std.2020.01472
AMA Tekinalp A,Demircioğlu S,BİLGEN H,Dikici H,Ceneli O B12 Vitamini Düzeyinin Multiple Miyelom Kliniğine Etkisi. Selçuk Tıp Dergisi. 2021; 37(1): 11 - 16. 10.30733/std.2020.01472
Vancouver Tekinalp A,Demircioğlu S,BİLGEN H,Dikici H,Ceneli O B12 Vitamini Düzeyinin Multiple Miyelom Kliniğine Etkisi. Selçuk Tıp Dergisi. 2021; 37(1): 11 - 16. 10.30733/std.2020.01472
IEEE Tekinalp A,Demircioğlu S,BİLGEN H,Dikici H,Ceneli O "B12 Vitamini Düzeyinin Multiple Miyelom Kliniğine Etkisi." Selçuk Tıp Dergisi, 37, ss.11 - 16, 2021. 10.30733/std.2020.01472
ISNAD Tekinalp, Atakan vd. "B12 Vitamini Düzeyinin Multiple Miyelom Kliniğine Etkisi". Selçuk Tıp Dergisi 37/1 (2021), 11-16. https://doi.org/10.30733/std.2020.01472