Characteristics of Vitamin B12 Deficiency in Patients With Plasma Cell Disorders

Braschi, Caitlyn; Doucette, John T.; Chari, Ajai

doi:10.1016/j.clml.2017.07.001

Cited by 7 publications

(9 citation statements)

References 35 publications

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“…This may suggest that other biological factors were implicated in the poor outcomes. Although vitamin B 12 deficiency can be found in patients with plasma cell disorders, it does not always cause macrocytosis and even patients with low MCV can have vitamin B 12 deficiency . In our study, the level of vitamin B 12 was not available in most patients, but it is unlikely to be the sole cause for the increased MCV.…”

Section: Discussionmentioning

confidence: 58%

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Hematopoietic score predicts outcomes in newly diagnosed multiple myeloma patients

et al. 2019

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Risk stratification of multiple myeloma (MM) at diagnosis is critical. We examined the ability of hematopoietic indices including mean corpuscular volume (MCV), hemoglobin (Hgb), and platelet (Plt) to predict outcomes. This was a retrospective study of patients treated at Mayo Clinic between January 2004 and April 2018. We incorporated three variables (Hgb < 10 g/dL, Plt < 150 × 10 9 /L, and MCV > 96 fL), assigning a score of 1 to each. We identified 1540 newly diagnosed MM patients, of whom 707 (46%) had a score of 0, 513 (33%) had a score of 1, 260 (17%) had a score of 2, and 60 (4%) had a score of 3. The score risk stratified patients into four groups with differing survivals. The median PFS was 32.3 months for score 0, 24.8 months for score 1, 21.7 months for score 2, and 18.3 months for score 3, for P < .001. The median OS was 80.7 months for score 0, 59.9 months for score 1, 51.7 months for score 2, and 31.3 months for score 3, P < .0001. Predictors of OS on the multivariable analysis were age ≥ 65 (HR, 1.93; P < .0001), R-ISS stage (1-2 vs 3) (HR, 0.48; P < .0001), and hematopoietic score (0-2 vs 3) (HR, 0.51; P = .006). A hematopoietic score can predict survival in newly diagnosed myeloma patients.

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Section: Discussionmentioning

confidence: 58%

“…Anemia is a prognostic marker used in the Durie‐Salmon Staging system and has been associated with worse survival . Vitamin B 12 deficiency can be found in patients with plasma cell disorders and ranges from 13%‐20%, but it is not solely the cause of anemia. Thrombocytopenia is also known to be predictive of worse outcomes .…”

Section: Introductionmentioning

confidence: 99%

Hematopoietic score predicts outcomes in newly diagnosed multiple myeloma patients

et al. 2019

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“…According to the literature, vitamin B12 de ciency has been reported in approximately 13-20% of patients with plasma cell disease (11,18,19). Regardless, this may not be related to macrocytosis in these patients, and some patients with vitamin B12 de ciency do not show an increase in their MCV (11,18). It is believed that increased an erythrocyte volume is more common in elderly patients, which may be related to the shortened erythrocyte life span and the emergence of more new erythrocytes (reticulocytes) to replace the lost red blood cells, resulting in a slightly larger volume (20) and an increased peripheral blood red blood cell distribution width (9,21).…”

Section: Discussionmentioning

confidence: 99%

Hematopoietic Score for the Prognostic Evaluation of Multiple Myeloma Patients Undergoing First-Line Treatment With A Bortezomib-Based Regimen

Yue

Han

et al. 2021

Preprint

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Background: It is very important to evaluate the prognosis of multiple myeloma (MM) patients before starting treatment. Although hematopoietic status may have a significant impact on patient survival, it has not received sufficient attention in current clinical practice. Methods: This was a retrospective study of 328 newly diagnosed MM patients received first-line treatment with a bortezomib-based regimen. The effects of hematopoietic factors, including hemoglobin (Hgb) levels, mean corpuscular volume (MCV), and platelet count (Plt) on the prognosis of the patients were analysed. Results: Hgb<100 g/L, MCV>99.1fL and Plt<150×109/L significantly affect the progression-free survival (PFS) and overall survival (OS) of MM patients, each of the above factors was assigned a value of 1 to generate a hematopoietic score. According to the results, 93 (28.4%), 103 (31.4%), 90 (27.4%) and 42 (12.8%) patients had a score of 0, 1, 2, 3, respectively. The median PFS were 38.7, 55.9, 23.9 and 16.7 months, respectively (P<0.001), and the median OS were not reached (NR), 68.4months, 53.6 and 33.2 months, respectively (P<0.001). Multivariable analysis showed that hematopoietic score (2-3 vs 0-1, HR, 1.64) and bone marrow plasma cell percentage (>30%, HR, 1.54) are independent prognostic predictors for PFS; age (≥70 years, HR, 1.67), hematopoietic score (2-3 vs 0-1, HR, 1.60), serum creatinine level (>177umol/L, HR, 2.15) and bone marrow plasma cell percentage (>30%, HR, 1.81) are independent prognostic predictors of OS. Conclusions: This study suggests that the hematopoietic score can be used to evaluate the prognosis of newly treated MM patients in the era of new drugs. However, there is still a need to enlarge the number of cases and carry out prospective research to validate this conclusion.

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“…An increased red blood cell volume is often an indication of folic acid or vitamin B12 de ciency; however, it is regrettable that only a few patients in our group were tested for serum vitamin levels, with no de ciency found. According to the literature, vitamin B12 de ciency has been reported in approximately 13-20% of patients with plasma cell disease (9,16,17). Regardless, this may not be related to macrocytosis in these patients, and some patients with vitamin B12 de ciency do not show an increase in their MCV (9,16).…”

Section: Multivariate Analysis Using Thementioning

confidence: 99%

“…According to the literature, vitamin B12 de ciency has been reported in approximately 13-20% of patients with plasma cell disease (9,16,17). Regardless, this may not be related to macrocytosis in these patients, and some patients with vitamin B12 de ciency do not show an increase in their MCV (9,16). It is believed that increased an erythrocyte volume is more common in elderly patients, which may be related to the shortened erythrocyte life span and the emergence of more new erythrocytes (reticulocytes) to replace the lost red blood cells, resulting in a slightly larger volume (18) and an increased peripheral blood red blood cell distribution width (12,19).…”

Section: Multivariate Analysis Using Thementioning

confidence: 99%

Haematopoietic Score for the Prognostic Evaluation of Multiple Myeloma Patients Undergoing First-line Treatment With a Bortezomib-based Regimen

Yue

Han

et al. 2020

Preprint

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Backgroud: It is very important to evaluate the prognosis of multiple myeloma (MM) patients before starting treatment. Although haematopoietic status may have a significant impact on patient survival, it has not received sufficient attention in current clinical practice.Methods:This was a retrospective study of 150 newly diagnosed MM patients treated in one hematonosis treatment centre from May 2013 to June 2016, all of whom received first-line treatment with a bortezomib-based regimen.The effects of haematopoietic factors, including haemoglobin levels (Hgb <100 g/L), mean corpuscular volume (MCV>99.1 fL), and platelet count (<150 × 10E9/L), on the prognosis of the patients were analysed. Each of the above factors was assigned a value of 1 to generate a haematopoietic score.Results: According to the results, 59 (39.3%) patients had a score of 0, 43 (28.7%) had a score of 1, 29 (19.3%) had a score of 2, and 19 (12.7%) had a score of 3. The median PFS times were 43.1, 24.5, 32.6 and 14.2 months, respectively (P<0.001), and the median OS times were NR, 47.1 months, NR and 31.4 months, respectively (P<0.001). Multivariable analysis showed that the R-ISS stage (3 vs 1-2, HR, 1.4), haematopoietic score (3 vs 0-2, HR, 1.91) and plasma cell percentage (>30%, HR, 1.96) are independent prognostic predictors for PFS; age (≤65 years, HR, 0.54), the Durie-Salmon stage (3B vs 1-3a, HR, 2.96), haematopoietic score (3 vs 0-2, HR, 2.53) and the bone marrow plasma cell percentage (>30%, HR, 2.35) are independent prognostic predictors of OS. Conclusion: This study suggests that the haematopoietic score can be used to evaluate the prognosis of newly treated MM patients in the era of new drugs. However, there is still a need to enlarge the number of cases and carry out prospective research to validate this conclusion.

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Characteristics of Vitamin B12 Deficiency in Patients With Plasma Cell Disorders

Cited by 7 publications

References 35 publications

Hematopoietic score predicts outcomes in newly diagnosed multiple myeloma patients

Hematopoietic score predicts outcomes in newly diagnosed multiple myeloma patients

Hematopoietic Score for the Prognostic Evaluation of Multiple Myeloma Patients Undergoing First-Line Treatment With A Bortezomib-Based Regimen

Haematopoietic Score for the Prognostic Evaluation of Multiple Myeloma Patients Undergoing First-line Treatment With a Bortezomib-based Regimen

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