Elevated Vitamin B12 Levels in Myeloproliferative Neoplasm (MPN) Patients - A Potential Diagnostic and Prognostic Marker

Sep 21, 2026

Elevated vitamin B12 (B12) has been associated with increased cancer risk, including hematological malignancies. This study evaluates the prevalence and clinical meaning of high B12 levels in myeloproliferative neoplasm (MPN) patients, focusing on polycythemia vera, primary myelofibrosis, essential thrombocytosis, and chronic myeloid leukemia. Data from Doha cancer care records (2016–2022) analyze median values, propose diagnostic cutoffs, and assess B12 sensitivity and specificity as a diagnostic/prognostic biomarker. Elevated B12 shows links to disease activity, particularly in CML.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Background

Aim

Methods

Results

Conclusion

Keywords

Journal of Blood Medicine Open Access Full Text Article ORIGINAL RESEARCH Elevated Vitamin B12 Levels in Myeloproliferative Neoplasm (MPN) Patients: A Potential Diagnostic and Prognostic Marker Abdalla Fadul 1 , Elmustafa Abdalla 1 , Anas Mohamed 1 , Bashir Ali 1 , Nusiba Elamin 1 , Ahmed Abdelghafar Alsayed 1 , Abdulrahman F Al-Mashdali 2 , Kalpana Singh 3 , Shehab F Mohamed2 1Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar; 2Department of Hematology, Hamad Medical Corporation, Doha, Qatar; 3Department of medical biostatistics, Hamad Medical Corporation, Doha, Qatar Correspondence: Abdalla Fadul, Department of Internal Medicine, Hamad Medical Corporation, Al-Rayyan Road, PO Box 3050, Doha, Qatar, Tel +97477999443, Fax +97444397857, Email [aabdu69044@gmail.com](aabdu69044@gmail.com) | Background: Elevated vitamin B12 (B12) levels are linked to an increased risk of cancers, including hematological malignancies. This study focuses on the relationship between elevated B12 and myeloproliferative neoplasms (MPNs): Polycythemia Vera (PV), Primary Myelofibrosis (MF), Essential Thrombocytosis (ET), and Chronic Myeloid Leukemia (CML) . Elevated B12 in MPNs is believed to arise from increased transcobalamin I (TCI) secretion by proliferating leukocytes, leading to higher serum levels. B12 may serve as a diagnostic and prognostic biomarker for these conditions. However, its sensitivity, specificity, and cutoff levels are unclear. Aim: To assess the prevalence of high B12 levels in MPN patients, determine the median levels, identify a diagnostic cutoff, and evaluate the sensitivity and specificity of B12 as a marker.
Methods: Data were retrieved from the National Center for Cancer Care and Research in Doha, Qatar, for MPN patients from January 2016 to December 2022.
Results: A total of 467 patients were included: 232 with CML, 98 with PV, 88 with ET, and 50 with MF. The majority were male (66%) and of Asian origin (56%), with a median age of 48.7 years. CBC results showed median hemoglobin of 9.2 g/dL, WBC count of 73 x 10^3/uL, and platelet count of 531 x 10^3/uL. Elevated B12 levels were found in 95 patients (20%): 71% CML, 14% PV, 10% MF, and 5% ET. Extreme elevations were seen in 59 patients. The mean B12 level decreased from 747.3 ± 686.5 pg/mL before treatment to 397.9 ± 343.7 pg/mL after one year (p=0.01). Median levels were 458 pg/mL (718) before treatment and 301 pg/mL (229) after. In the extreme high B12 group, the mean was 1722 pg/mL before and 677 pg/mL after treatment.
Conclusion: Elevated B12 levels are associated with disease activity in CML. However, their role as a reliable marker for disease monitoring remains uncertain, and further studies are needed to confirm their utility for CML progression.
Keywords: Vitamin B12, myeloproliferative neoplasms, MPNs, chronic myeloid leukemia, CML, polycythemia vera, PV, essential thrombocythemia, ET, myelofibrosis, MF | | --- | | Introduction
Myeloproliferative neoplasms (MPNs) are a heterogeneous group of clonal hematopoietic disorders characterized by the abnormal proliferation of myeloid lineage cells, leading to a spectrum of clinical presentations, complications, and an increased risk of transformation to acute leukemia.1 These disorders include chronic myeloid leukemia (CML), polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF) . Each MPN subtype is associated with specific genetic mutations—such as the BCR-ABL fusion gene in CML, or JAK2, CALR, and MPL mutations in BCRABL-negative MPNs.2 These mutations, along with their distinct pathophysiological mechanisms, contribute to the diagnostic and therapeutic challenges that clinicians face in managing these diseases.2
In recent years, there has been growing interest in identifying reliable biomarkers that can enhance the accuracy of MPN diagnosis, improve risk stratification, and aid in monitoring disease progression. Traditionally, the diagnosis

FAQs

What conditions and patient groups were evaluated in this study?

The study assessed myeloproliferative neoplasm patients with polycythemia vera, primary myelofibrosis, essential thrombocytosis, and chronic myeloid leukemia, using data from 2016 to 2022.

How common were elevated vitamin B12 levels among the included MPN patients?

Elevated B12 levels were found in 95 of 467 patients (20%), with most cases occurring in CML.

What did the study find about changes in B12 levels after treatment?

Mean B12 levels decreased from before treatment to after one year, with the extreme-high B12 group also showing a substantial reduction after treatment.

Sep 21, 2026

Upload by Theodora