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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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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.
Accepted: March 31, 1971
Received: October 14, 1970
☆This study was supported by United States Air Force funds made available through AFR No.169-6.
© 1971 Published by Elsevier Inc.