Recovery from anemia and leukocytopenia after abstinence in Japanese alcoholic men and their genetic polymorphisms of alcohol dehydrogenase-1B and aldehyde dehydrogenase-2.
BACKGROUND
The combination of the fast-metabolizing alcohol dehydrogenase-1B (ADH1B*2 allele) and inactive heterozygous aldehyde dehydrogenase-2 (ALDH2*1/*2) increases susceptibility to macrocytic anemia and leukocytopenia in alcoholics due to severe acetaldehydemia. More than half of Japanese drinkers with esophageal cancer have this genotype combination.


METHODS
To assess the recovery of hematologic abnormalities after drinking cessation, changes in blood erythrocyte indices and leukocyte count during 8-week hospital stay were evaluated in 925 Japanese alcoholic men. We used four categories in ascending order for high blood acetaldehyde exposure from drinking: A, ADH1B*1/*1 plus ALDH2*1/*1; B, ADH1B*2 plus ALDH2*1/*1; C, ADH1B*1/*1 plus ALDH2*1/*2; and D, ADH1B*2 plus ALDH2*1/*2.


RESULTS
Mean values of hemoglobin and hematocrit were the lowest, and those of mean corpuscular volume (MCV) were markedly the highest in the D group on admission, and returning toward normal after abstinence, but the inter-group differences remained significant throughout the 8 weeks. The mean leukocyte count was the lowest in the D group on admission, but increased during 4-week abstinence when the inter-group differences were no longer significant. Frequencies of MCV ≥110 fl (50.5%), hemoglobin levels <11.5 g/dL (32.7%), hemoglobin levels <10.0 g/dL (9.9%) and leukocytopenia <4000/μL (22.8%) were the highest in the D group on the admission day and decreased at the 4-week abstinence (28.7%, 18.8%, 4.0% and 7.9%, respectively). The inter-group differences in frequencies of the severe anemia and leukocytopenia disappeared after 4-week abstinence.


CONCLUSIONS
Drinking cessation before surgery and/or chemoradiation treatment for esophageal cancer may be effective for recovery from anemia and leukocytopenia in drinkers belonging to the D group.
National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa, Japan.
Akira
A
Yokoyama
Division of Clinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA.
Philip J
PJ
Brooks
Department of Health Promotion, National Institute of Public Health, Saitama.
Tetsuji
T
Yokoyama
National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa, Japan.
Takeshi
T
Mizukami
Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo , Japan.
Shunsuke
S
Shiba
Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo , Japan.
Nobuhiro
N
Nakamoto
National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa, Japan.
Katsuya
K
Maruyama
D000328:Adult; D000426:Alcohol Dehydrogenase / Q000378:metabolism*; D000437:Alcoholism / Q000150:complications*; D000444:Aldehyde Dehydrogenase / Q000378:metabolism*; D000740:Anemia / Q000628:therapy*; D006801:Humans; D007970:Leukopenia / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic
D000426:Alcohol Dehydrogenase; D000444:Aldehyde Dehydrogenase
alcohol dehydrogenase-1B; aldehyde dehydrogenase-2; esophageal cancer; leukocyte; macrocytic anemia