Wednesday, October 17, 2018

Why is the level of Vitamin B12 increased in CML?

Why is the level of Vitamin B12 increased in Chronic Myeloid Leukemia (CML)?

Pathophysiology: The transport of vitamin B12 in the blood as well as hepatic uptake require the presence of transcobalamins (TCBs).

TCB types I (TCB I) and III (TCB III) ensure the binding of ∼80% of circulating vitamin B12.

TCB II transports cobalamins in serum.

➡️ It is an essential protein in the delivery of vitamin B12 to cells and tissues (active fraction of serum vitamin B12 assayed) although it only transports 20% of circulating cobalamins.

⭐️ So, TCB II plays the predominant role in the key processes of tissue and hepatic uptake of vitamin B12.

Liver storage of vitamin B12 is mediated by endothelial cells, hepatocytes being naturally devoid of TCB II receptors.

✔️High Yield information:

TCB I and III

➡️ Derived from the granulocyte line

➡️ Markers of neutrophilic secondary granules explains their increase in myeloproliferative disorders (MPDs).

PS: The Myeloproliferative Disorders are polycythemia vera, essential thrombocythemia, myelofibrosis and CML.

So, that’s why Vitamin B12 increased in CML.

Submitted by Drashtant from B.J. Medical College 

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