Vitamin B(12)-responsive pancytopenia mimicking myelodysplastic syndrome.

[akita]

Vitamin B(12)-responsive pancytopenia mimicking myelodysplastic syndrome.

Korean researchers report 12 patients who were initially diagnosed with MDS and responded to parenteral Vitamin B12 treatment.

From 255 consecutive patients diagnosed with MDS

99 patients showing morphological features of Low-Risk-MDS were chosen for the study.

45 of them had normal karyotypes. These were treated with Vitamin B12 as intramuscular injections of cobalamide at a dose of 1mg per day for 1 week

12 of them responded rapidly.

These were 7 patients with the initial diagnosis MDS - RCMD and 5 with MDS - RA. One of them had 7 % blasts in the bone marrow.

--
Parenteral Vitamin B12 was used as a diagnostic tool and 26,66 % of the study-patients responded even with Vitamin B12-levels in the normal range! There are more studies/reports on this topic. It would have probably been useful also to form other groups of MDS-diagnosed patients and then see how big the "success"-quote would have been.

There was at least one man reported having been admitted already for stem cell transplantation for MDS who responded to vitamin B12 treatment and could leave the hospital with his own bone marrow.. This is reported by Dr. Hermann Heimpel, a German Hematologist, in the commentary on the abovementioned study.

His comment finishes: "In the last decade, I have seen a number of patients with aplastic anemia, congestive splenomegaly, or congenital dyserythropoetic anemia which were erroneously diagnosed as any type of MDS. This experience and the report by Kim at al (= the korean study) reaffirm the need for utmost care with the diagnosis of MDS, which is probably the most frequent erroneous diagnosis in cases with unclassified anemia or pancytopenia."

Some patients might be sad when Vitamin B12 supplementation (high dosis, regime) does not help for their diagnoses/blood counts. Sorry for bringing further inconvenience to some of them by posting this. But hopefully it could help for a few patients. Please communicate to your doctors!

Margarete


----
Study:
http://www.ncbi.nlm.nih.gov/pubmed/21252496

Comment:
http://www.ncbi.nlm.nih.gov/pubmed/21487214

P.S. The fulltext is not free. I could get it from our Viennese Library of the Medical University as a user of it. If anybody of you in the forum would have a special interest in details of the study (e.g. special counts of patients) i hope it is allowed by copyright to mail him/her a few further details.

[Marlene]

Thanks for highlighting this. Even if B12 does not help blood counts, it is still helpful during recovery of the bone marrow after treatment. There is so much stress placed on the marrow and during times of stress, the body needs more than it normally would.

It makes sense that B12 would be the first line of treatment to try especially when their serum B12 levels are in the low to middle normal levels.