Incidence of Cobalamin, Iron, and Folate Deficiency Levels caused by Multiple MyelomaInto Diagnosed Patients. A Cross-Sectional Study

Multiple Myeloma: Incidence of B12, Iron, and Folate Deficiencies

Abstract

Background: Plasma cell malignancy, known as multiple myeloma, can present with anemia. Micronutrient deficiencies, especially of cobalamin (vitamin B12), iron, and folate, can cause severe anemias, although, as a rule, anemia is attributed to marrow infiltration and renal dysfunction.

Objectives: The incidence of cobalamin, iron, and folate deficiencies in newly diagnosed and treatment-naive multiple myeloma patients and their correlation with baseline hematologic parameters were determined.

Methods: A total of 80 newly diagnosed multiple myeloma patients were included in this cross-sectional study. Before the start of therapy, the serum levels of vitamin B12, ferritin, transferrin saturation, and red cell folate were measured. Cobalamin deficiency cut-offs were defined as < 200 pg/mL (serum), < 30 ng/mL (ferritin) or < 20% (transferrin saturation), red cell folate < 150 ng/mL. SPSS Version 26 was used to compare hematologic parameters between deficient and non-deficient groups.

Results: The patients presented cobalamin deficiency in 37.5%, iron deficiency in 31.3%, and folate deficiency in 22.5%. About 56.3% had one or more deficiencies, and 15% had combined deficiencies. Specifically, patients with any deficiency had a mean hemoglobin (9.2 g/dL vs. 10.8 g/dL; p = 0.001) and mean corpuscular volume (95.1 fL vs. 88.3 fL; p < 0.001) significantly lower than those with no deficiencies.

Conclusion: Newly diagnosed multiple myeloma is associated with a very high prevalence of micronutrient deficiencies, particularly of cobalamin and iron, and deficiency anemia. A routine screening and correction of these deficiencies should be included as part of the initial evaluation to improve hematologic status and treatment outcomes.