title: Type B lactic acidosis as a severe metabolic complication in lymphoma and leukemia: a case series from a single institution and literature review.
abstract: Type B lactic acidosis is a rare complication of hematologic malignancies. The exact mechanism of this process is not well understood. Because caregivers may not be aware of the association of type B lactic acidosis with hematologic malignancies, it may go unrecognized as a cause of acidosis in these patients. We report the cases of 7 patients with type B lactic acidosis who were cared for by members of the Brown Medical School Hematology/Oncology Division. Of the 7 patients reported, 5 had lymphomas and 2 had chronic lymphocytic leukemia. One of the lymphomas was a T-cell lymphoma. Of the patients we were able to evaluate, there did not seem to be a unique cluster of differentiation marker in association with type B lactic acidosis. We also review 14 additional cases, most reported since 2001. From our review of the literature, we suggest that a deficiency of thiamine or riboflavin may play a more pivotal role than previously recognized in the development of type B lactic acidosis associated with malignancy. Further investigation should be undertaken to learn if thiamine or riboflavin replacement might be useful in treating this disorder.
authors.affiliation: From Division of Hematology/Oncology, Brown Medical School/Rhode Island and Miriam Hospitals, Providence, Rhode Island.
authors.forename: Allison S
authors.initials: AS
authors.lastname: Friedenberg
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Brandoff
authors.forename: Fred J
authors.initials: FJ
authors.lastname: Schiffman
mesh_terms: D000140:Acidosis, Lactic / Q000209:etiology*; D000368:Aged; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications*; D015470:Leukemia, Myeloid, Acute / Q000150:complications*; D008228:Lymphoma, Non-Hodgkin / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies