The Association of Vitamin B12 and Folic Acid Levels with the Effects of Induction Chemotherapy in Acute Leukemia Patients

Abstract

Introduction: It is essential to achieve remission with induction chemotherapy and then to provide normal hematopoiesis as fast as possible in acute leukemia (AL) patients in order to minimize treatment-related problems. Both vitamin B12 (vitB12) and folic acid (FA), which are both essential vitamins in the process of cell proliferation, affect the process of reestablishing normal hematopoiesis. In patients who have AL, the purpose of this study is to explore the connection between vitB12 and FA and the accomplishment of hematological remission and bone marrow recovery following induction chemotherapy, as well as infection during induction. Methods: A retrospective study was conducted on the collected information of 71 AL patients who were diagnosed and monitored at the department of hematology between February 2012 and May 2017. The patients’ ages ranged from 21 to 67 years, with 47 being the median age. There were 37 male and 34 female patients. Results: The median level of vitB12 was 386 pg/mL, with a range of 71-2000, while the median level of FA was 5.57 ng/mL, with a range of 2-19. A total of 57 patients (80.3%) reacted favorably to the induction chemotherapy, whereas 14 patients or 19.7%, did not. There were 67 individuals who had febrile neutropenia (94.4%) and 20 patients who developed a fungal infection (28.6%). The correlation between vitB12 and FA levels with remission, bone marrow recovery, duration of febrile neutropenia, and fungal infection was investigated, and the results showed that there was no statistical significance (p>0.05). Conclusion: It was not possible to establish a connection between vitB12 and FA and the accomplishment of hematological remission and bone marrow recovery, as well as infections during induction chemotherapy in AL patients.

Keywords

• vitamin b12
• folic acid
• acute leukemia