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Research Article| Volume 78, ISSUE 2, P289-297, August 1971

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Nonleukemic elevation of serum vitamin B12 and B12-binding capacity levels resembling that in chronic myelogenous leukemia

  • Ralph Carmel
    Correspondence
    Reprint requests: Dr. Ralph Carmel, MRC Experimental Haematology Unit, St. Mary's Hospital Medical School, London W, 2, England.
    Affiliations
    From the Aerospace Medical Laboratory (Clinical) and the Hematology-Oncology Service, Wilford Hall USAF Medical Center Lackland AFB, Texas, USA
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  • Charles A. Coltman Jr.
    Affiliations
    From the Aerospace Medical Laboratory (Clinical) and the Hematology-Oncology Service, Wilford Hall USAF Medical Center Lackland AFB, Texas, USA
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      Abstract

      In vitro serum vitamin B12 abnormalities characteristic of chronic myelogenous leukemia were found in 5 patients without leukemia. All had leukocytosis, and 3 transiently had immature myeloid cells in peripheral blood. The B12 abnormalities were: (1) marked elevation of alpha-globulin B12-binding capacity in all subjects and (2) high serum B12 levels in 3 patients with high-normal levels in 2. Beta-globulin binding was normal in 2 but elevated in the others. Electrophoretic and reticulocyte uptake studies also demonstrated the findings seen in chronic myelogenous leukemia. Of 3 patients studied at different stages, one's abnormalities disappeared as leukocytosis subsided, one's improved similarly but quickly rebounded as leukocytosis returned, and the third remained abnormal as leukocytosis persisted. A patient recovering from agranulocytosis due to chemotherapy was studied serially. The B12 abnormalities paralleled the recovery phase to the exact day, returning to normal as leukocytosis subsided. High alpha-globulin B12 binding and, often, serum B12 levels resembling those in chronic myelogenous leukemia, thus, are not infrequently found in nonleukemic leukocytosis. The exact mechanisms responsible remain unknown. However, it is apparent that the abnormality is not an expression of the leukemic process itself and is not diagnostic for the disease.
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      References

        • Beard MF
        • Pitney WR
        • Sanneman EH
        Serum concentrations of vitamin B12 in patients suffering from leukemia.
        Blood. 1954; 9: 789-794
        • Mollin DL
        • Ross GIM
        Serum vitamin B12 concentrations in leukaemia and in some other haematological conditions.
        Brit J Haemat. 1955; 1: 155-172
        • Miller A
        • Sullivan JF
        The in vitro binding of cobalt-60-labeled vitamin B12 by normal and leukemic sera.
        J Clin Invest. 1958; 37: 556-566
        • Miller A
        • Sullivan JF
        Electrophoretic studies of the vitamin B12-binding protein of normal and chronic myelogenous leukemia serum.
        J Clin Invest. 1959; 38: 2135-2143
        • Mendelsohn RS
        • Watkin DM
        • Horbett AP
        • et al.
        Identification of the vitamin B12-binding protein in the serum of normals and of patients with chronic myelocytic leukemia.
        Blood. 1958; 13: 740-747
        • Hall CA
        • Finkler AE
        Measurement of the amounts of the individual vitamin B12-binding proteins in plasma. II. Abnormalities in leukemia and pernicious anemia.
        Blood. 1966; 27: 618-622
        • Gottlieb CW
        • Retief FP
        • Pratt PW
        • et al.
        Correlation of B12-binding proteins with disorders of B12 metabolism.
        J Clin Invest. 1966; 45: 1016
        • Meyer LM
        • Cronkite EP
        • Miller IF
        • et al.
        Co60 vitamin B12-binding capacity of human leukocytes.
        Blood. 1962; 19: 229-235
        • Simons K
        • Weber T
        The vitamin B12-binding protein in human leukocytes.
        Biochim Biophys Acta. 1966; 117: 201-208
        • Stenman V-H
        • Simons K
        • Gräsbeck R
        Vitamin B12-binding protein in normal and leukemic human leukocytes and sera.
        Scand J Lab Clin Invest. 1968; 21: 202-210
        • Carmel R
        • Coltman CA
        Radioassay for serum vitamin B12 with the use of saliva as the vitamin B12 binder.
        J Lab Clin Med. 1969; 74: 967-975
        • Gottlieb C
        • Lau KS
        • Wasserman LR
        • et al.
        apid charcoal assay for intrinsic factor (IF), gastric juice-unsaturated B12 binding capacity, antibody to IF, and serum-unsaturated B12-binding capacity.
        Blood. 1965; 25: 875-884
        • Silverstein E
        • Herbert V
        Rapid determination of vitamin B12-binding alpha and beta globulin in serum.
        Blood. 1968; 31: 518-521
        • Retief P
        • Gottlieb CW
        • Herbert V
        Delivery of Co57B12 to erythrocytes from alpha and beta globulin of normal, B12-deficient, and chronic myeloid leukemia serum.
        Blood. 1967; 29: 837-851
        • Simons K
        Vitamin B12 binders in human body fluids and blood cells.
        Comment Biol Soc Sci Fenn. 1964; 27: 5
        • Beard MF
        • Pitney WR
        • Sanneman EH
        • et al.
        Serum concentrations of vitamin B12 in acute leukemia.
        Ann Intern Med. 1954; 41: 323-327
        • Erdmann-Oehlecker S
        • Heinrich HC
        Der Vitamin B12-Stoffwechsel bei Hämoblastosen.
        Clin Chim Acta. 1956; 1: 269-286
        • Rachmilewitz M
        • Izak G
        • Hochman A
        • et al.
        Serum vitamin B12 in leukemias and malignant lymphomas.
        Blood. 1957; 12: 804-813
        • Meyer LM
        • Bertcher RW
        • Cronkite EP
        • et al.
        Co60 vitamin B12-binding capacity of serum in persons with hematologic disorders, various medical diseases, and neoplasms.
        Acta Med Scand. 1961; 169: 557-575
        • Mikkonen L
        • Finkler AE
        • Hall CA
        A diagnostic test for chronic myelogenous leukemia based on abnormalities of B12-binding.
        Acta Med Scand. 1967; 181: 591-596
        • Hall CA
        • Finkler AE
        Vitamin B12-binding protein in polycythemia vera plasma.
        J Lab Clin Med. 1969; 73: 60-69
        • Carmel R
        • Coltman CA
        Serum vitamin B12 binding in nonleukemic leukocytosis.
        Clin Res. 1970; 18: 40
        • Carmel R
        • Coltman CA
        Serum vitamin B12-binding capacity and muramidase changes with cyclic neutropenia induced by cytosine arabinoside.
        Blood. 1971; 37: 31-39
        • Olesen H
        • Andersen MP
        • Amris A
        Serum vitamin B12-binding capacity in patients with anemia.
        Scand J Haemat. 1968; 5: 235-240
        • Corcino J
        • Krauss S
        • Waxman S
        • et al.
        Release of vitamin B12—binding protein by human leukocytes in vitro.
        J Clin Invest. 1970; 49: 2250-2255
      1. Carmel R: Vitamin B12—binding protein abnormality in subjects without myeloproliferative disease. II. The presence of a third B12—binding protein in serum. Submitted for publication.