Thiamine deficiency in patients with B-chronic lymphocytic leukaemia: a pilot study
Thiamine deficiency in patients with B-chronic lymphocytic leukaemia: a pilot study
复制标题
DOI：
10.1136/pmj.77.911.582
复制
发表时间：
2001-09-01
影响因子：
5.1
通讯作者：
Prokocimer, M
中科院分区：
文献类型：
--
作者：
Seligmann, H;Levi, R;Prokocimer, M
恶性肿瘤相关的原发性硫胺素缺乏症已在几个实验性肿瘤、零星临床病例报告和一些快速增长的血液系统恶性肿瘤患者中被证实。前瞻性地评估了14名未经治疗的慢性B淋巴细胞白血病(CLL)患者和14名年龄匹配的非恶性疾病对照患者的硫胺状态。排除了绝对、相对或功能性硫胺素缺乏的任何已知原因的患者。14例慢性淋巴细胞性白血病患者中有5例(35.7%)发现高(15%)硫胺素焦磷酸效应，表明硫胺素缺乏(35.7%)，而在对照组中没有发现(p=0.057)。硫胺素缺乏组的平均(SD)TPPE为21.6(3.4)%。在所有患者中，硫胺素缺乏都是亚临床的。目前还没有发现与硫胺素缺乏相关的因素，除了在过去三个月中，所有5名硫胺素缺乏症患者的白细胞总数增加了20%以上，而9名非硫胺素缺乏症患者中只有一人发现了这一点。因此，CLL患者可能容易发生原发性硫胺素缺乏症，这可能是由于白细胞跨度的增加而导致的，这可能会增加硫胺素的摄入量。由于即使亚临床硫胺素缺乏也可能损害患者的临床病程，鉴于硫胺素促进肿瘤细胞增殖的理论危险，有必要进行进一步的大规模研究来证实这一观察结果，并阐明对CLL患者补充硫胺素的问题。
Malignancy associated primary thiamine deficiency has been documented in several experimental tumours, sporadic clinical case reports, and in a number of patients with fast growing haematological malignancies.Thiamine status was assessed prospectively in 14 untreated B-chronic lymphocytic leukaemia (CLL) patients, and in 14 age matched control patients with nonmalignant disease. Patients with any known cause of absolute, relative, or functional thiamine deficiency were excluded.High (>15%) thiamine pyrophosphate effect (TPPE), indicating thiamine deficiency, was found in five out of 14 CLL patients (35.7%) and in none of the controls (p=0.057). Mean (SD) TPPE in the thiamine deficient patients group was 21.6 (3.4)%. In all the patients, thiamine deficiency was subclinical. No correlates for the thiamine deficiency have been found save for an increment of more than 20% in the total leucocyte count over the preceding three months, which was found in all five thiamine deficient patients compared with only one of the nine nonthiamine deficient CLL patients.Thus, CLL patients may be prone to develop primary thiamine deficiency possibly promoted by the increased leucocytes span, which may increase thiamine consumption. Since even subclinical thiamine deficiency may be detrimental to the patient's clinical course, and in view of the theoretical danger of thiamine promoted tumour cell proliferation, further large scale studies are warranted to confirm this observation, and to elucidate the issue of thiamine supplementation to CLL patients.