Researchers from the Cleveland Clinic have reported that 13.6% of patients with plasma cell dyscrasias have vitamin B12 deficiency. They suggest that “serum vitamin B12 measurements should be part of the initial evaluation and subsequent workups for anemia in patients with plasma cell dyscrasias.” The details of this report appeared in the August 2004 issue of Cancer .
Vitamin B12 status of patients with plasma cell dyscrasias has not previously been reported. These researchers looked at the vitamin B12 status of 664 patients with plasma cell dyscrasias. This study included 132 patients with MGUS, 320 with multiple myeloma, 43 with amyloid, 14 with plasmacytoma and 10 with smoldering MM. Of this group, 522 had adequate studies for evaluation in this retrospective analysis. They found that 13.6% of patients met the criteria for vitamin B12 deficiency. Vitamin B12 deficiency was more common among patients with IgA monoclonal protein compared to IgG or IgM. They also stated that “neither MCV, nor the presence of anemia is predictive of this deficiency.” They emphasized that B12 testing should not be dependent on the presence of “anemia, macrocytosis and unexplained neuropathy.”
Comments: This paper strongly suggests that vitamin B12 measurements be part of the initial evaluation of patients with plasma cell disorders.
Reference: Baz R, Alemany C, Green R, et al. Prevalence of vitamin B12 deficiency in patients with plasma cell dyscrasias. Cancer . 2004;101:790-795.
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