Der vitamin B 12-stoffwechsel bei hamoblastosen : I. Serumspiegel und harnexkretion der B 12-vitamine bei hämoblastosen

Abstract

The microbiological vitamin Big determination on the serum and urine of patients with various forms of hcmoblastosis was carried out with the phytoflagellates Euglena gracilis variatio saccharofthila isol. T and the chrysomonad Ochromonas malhamensis Pringsheim. In cases of chronic mycloid leucaemia the serum-vitamin B 12 concentrations found (510-11,900μγ/ml) were 2–50 times that of normal values, while no relation between the height of the serum-vitamin B 12 level and the number of leucocytes or their degree of maturation could be detected. On the other hand, in infectious leucocytosis the serum-vitamin B 12 values were decreased to the lower region of the normal range. After X-ray irradiation of the spleen in cases of chronic myeloid leucaemia the serum-vitamin B 12 level is also greatly lowered during the remission which follows the drop in the number of leucocytes. The excretion of vitamin B 12 in the urine, which was pathologically lowered before the therapy, increases greatly. With a recurrence of the disease the serum-vitamin B 12 level again rapidly reaches extremely high values. X-ray irradiation of other patients with tumours has no appreciable influence on the height of the serum-vitamin B 2 concentration. A greatly increased vitamin B 2 level was also found in many patients with acute leucaemia and polycythaemia. In the case of the patient with acute leucaemia a decrease in the pathologically high serum-vitamin B 12 value was found during the remission after cytostatic therapy. In chronic lymphatic leucaemia in addition to normal vitamin B 2 some very low levels are found in the serum and urine, especially in penultimate or progressive stages of the disease, as has also been observed in penultimate stages of lymphogranulomatosis and plasmocytoma. This vitamin Bia-hypovitaminosis cannot be attributed to the advanced age of the patients, as a comparison group showed a normal serum-vitamin B 12 level.