Thiamine deficiency in patients with B-chronic lymphocytic leukaemia: a pilot study

Abstract

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 eVect (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. (Postgrad Med J 2001;77:582-585)

Nonalcoholic Thiamine-Related Encephalopathy (Wernicke-Korsakoff Syndrome) Among Inpatients With Cancer: A Series of 18 Cases

“…Higher rates of TD among patients with cancer have been reported in several small studies. 5,24 WKS has also been reported in cancer. The prevalence of WKS in patients who died following bone marrow transplants has been estimated in 2 studies, with estimates ranging from 6–33%.…”

Thiamine (vitamin B1) deficiency and associated brain damage is still common throughout the world and prevention is simple and safe!

“…Thiamine deficiency is also reported in a significant proportion of patients with leukaemia. Of 14 chronic lymphatic leukaemia patients, 37.5% had thiamine deficiency although there were no obvious clinical manifestations [20]. The authors speculated that the primary thiamine deficiency is promoted by the increased leucocyte count, which may increase thiamine consumption.…”

Serum metabolome analysis by 1H-NMR reveals differences between chronic lymphocytic leukaemia molecular subgroups

“…Increased serum pyruvate can also be caused by deficiencies in thiamine, the physiologically active form of which, thiamine pyrophosphate, acts as a coenzyme in pyruvate decarboxylation. Seglimann et al 62 have reported comparatively high rates of thiamine deficiency in CLL patients and have proposed that this may be due to increased whole body requirements of energy and thiamine, increased thiamine consumption by tumour cells and finally, impaired thiamine phosphorylation. Although detectable using 1 H-NMR, serum concentrations of thiamine were too low to be assessed in this study.…”