Serum Folate and Vitamin B۱۲ Levels in Survivors of Childhood Malignancy in Southern Iran

Background: Folate and vitamin B۱۲ have a number of biologic roles that make them important in hematological disorders and malignancy. In the present study, we have assessed serum folate and vitamin B۱۲ levels and their associated variables in patients with leukemia, lymphoma, and solid tumors.Methods: This cross-section study investigated ۹۸ patients (۵۷ with leukemia, ۱۶ lymphoma, and ۲۵ solid tumors) between April ۲۰۱۵ and March ۲۰۱۶ in Southern Iran. Complete blood counts and serum levels of folate, vitamin B۱۲, lactate dehydrogenase, and homocysteine were measured. Clinical characteristics of the patients were also gathered from their medical records.Results: Patients had the following mean serum levels: serum folate (۱۲.۲۷±۶.۶۹ ng/ml), vitamin B۱۲ (۳۳۱.۸۱±۱۸۳.۲۲ pg/ml), and homocysteine (۱۱.۷۴±۲۶.۶۷ μmole/L). Vitamin B۱۲ showed a significant negative correlation with homocysteine levels (r= -۰.۲۲۳, P=۰.۰۴۳). Overall, there were ۲۱(۲۱.۹%) vitamin B۱۲ and ۹ (۹.۸%) folate deficient patients. Vitamin B۱۲ patients had a longer remission time (time from off therapy until study entry) of ۱۸±۱۶.۹۷ months compared to those with normal vitamin B۱۲ levels (۸.۸۱±۸.۰۸ months, P=۰۲۵). However, logistic regression analysis showed that only mean corpuscular volume had a significant correlation with vitamin B۱۲ deficiency (B= -۰.۱۰۵, odds ratio=۰.۹, ۹۵% CI: ۰.۸۱۹-۰.۹۹۰, P=۰.۰۳). None of the variables showed significant correlation with folate deficiency (P>۰.۰۵).Conclusion: Vitamin B۱۲ and folate deficiency are frequently seen in survivors of childhood malignancy, mainly due to the effects of chemotherapy. These vitamins have important roles in hematopoiesis, as well as development and maintenance of the nervous system; therefore, timely detection of their deficiencies is of utmost importance. It is highly recommended to check the serum levels of these vitamins in children who successfully survive their cancer treatments.