Hyperhomocysteinemia and functional cobalamin deficiency due to granulocytosis-induced alterations in the cobalamin-binding protein.
Serum cobalamin and homocysteine levels were studied in patients with chronic myelogenous leukemia (CML) and in stem cell donors treated with granulocyte-colony stimulating factor (G-CSF). Cytoreductive treatment in patients with CML resulted in a decrease of cobalamin and homocysteine levels. In stem cell donors cobalamin and homocysteine levels increased after G-CSF administration. The increase of homocysteine level was accompanied by a decrease in the serum levels of the cobalamin-binding protein transcobalamin. We hypothesize that the increased homocysteine levels in patients with CML and donors treated with G-CSF may be the result of a functional methylcobalamin deficiency due to decreased transcobalamin levels.
Department of Internal Medicine, Bronovo Hospital, Bronovolaan 5, 2597, AX The Hague, The Netherlands. tomvlasveld@hotmail.com
Lodewijk Thomas
LT
Vlasveld
Gerard M J
GM
Bos
Anton A M
AA
Ermens
Jaap A
JA
Bakker
Jan
J
Lindemans
D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood / Q000188:drug therapy; D014155:Transcobalamins / Q000378:metabolism*; D014805:Vitamin B 12 / Q000031:analogs & derivatives / Q000097:blood; D014806:Vitamin B 12 Deficiency / Q000097:blood*
D014155:Transcobalamins; D016179:Granulocyte Colony-Stimulating Factor; C019476:mecobalamin; D014805:Vitamin B 12