Hematological response to short-term oral cyanocobalamin therapy for the treatment of cobalamin deficiencies in elderly patients.
OBJECTIVE
The aim of this trial was to demonstrate the efficacy of one month of oral cobalamin (vitamin B12) therapy in elderly patients with cobalamin deficiency related to food-cobalamin malabsorption (FCM).


METHODS
Twenty elderly patients (mean age: 78+/-17 years) with established cobalamin deficiency related to FCM were included in an open-label, non-randomized, non-placebo trial. They were treated with a maximum of 1,000 microgram per day of oral crystalline cyanocobalamin for at least 1 month. Serum cobalamin levels (primary endpoint), blood count abnormalities and reticulocytes count (secondary endpoints) were determined at baseline and during the first month of treatment.


RESULTS
85% of the patients normalized their serum cobalamin levels with a mean increase of+167 pg/ml (p<0.001 compared with baseline). 100% of the patients corrected their initial macrocytosis and 25% their anemia; 100% of the patients had medullar regeneration with a mean increase of reticulocytes count of 32+/-11.3 x 106/l (p=0.03 compared with baseline).


CONCLUSIONS
Our findings support the view that one month of oral crystalline cyanocobalamin is effective to correct serum vitamin B12 levels and to obtain hematological responses in elderly patients with cobalamin deficiency related to FCM.
Andrès
E
E
Department of Internal Medicine, Hopitaux Universitaires de Strasbourg, 67 091 Strasbourg cedex, France. emmanuel.andres@chru-strasbourg.fr
Kaltenbach
G
G
Noblet-Dick
M
M
Noel
E
E
Vinzio
S
S
Perrin
A E
AE
Berthel
M
M
Blicklé
J F
JF
D000284:Administration, Oral; D000368:Aged; D000375:Aging / Q000502:physiology; D001772:Blood Cell Count; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007408:Intestinal Absorption; D008286:Malabsorption Syndromes / Q000150:complications* / Q000188:drug therapy; D008297:Male; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000008:administration & dosage / Q000097:blood* / Q000627:therapeutic use*; D014806:Vitamin B 12 Deficiency / Q000188:drug therapy* / Q000209:etiology
D006454:Hemoglobins; D014805:Vitamin B 12