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Thiamine deficiency in hematologic malignant tumors.

H C van Zaanen1, J van der Lelie

  • 1Department of Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands.

Cancer
|April 1, 1992
PubMed
Summary

Acute myeloid leukemia can cause thiamine (vitamin B1) deficiency, leading to severe heart failure. Prompt thiamine supplementation can treat this potentially fatal condition in cancer patients.

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Area of Science:

  • Hematology
  • Oncology
  • Nutritional Biochemistry

Background:

  • Acute myeloid leukemia (AML) can present with severe congestive heart failure.
  • Thiamine (vitamin B1) is essential for cellular energy metabolism, particularly in high-energy-demand cells like leukocytes.
  • Leukocytes have higher concentrations of thiamine-dependent enzymes than erythrocytes.

Observation:

  • A patient with AML and severe heart failure showed improvement with thiamine treatment.
  • Blast cells in leukemia may consume excessive thiamine, leading to deficiency.
  • The thiamine pyrophosphate (TPP) effect was measured in five patients with hematologic malignancies.

Findings:

  • One patient exhibited a definite thiamine deficiency with severe cardiac failure.
  • Two other patients showed a slightly elevated TPP effect, indicating potential thiamine depletion.
  • This suggests a link between fast-growing hematologic cancers and thiamine deficiency.

Implications:

  • Clinicians should consider thiamine deficiency in nonalcoholic patients with hematologic cancers presenting with heart failure.
  • This deficiency is underdiagnosed, potentially fatal, but treatable with thiamine supplementation.
  • Early identification and treatment can improve outcomes for cancer patients with cardiac complications.

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