Vitamin B12 absorption after allogeneic bone marrow transplantation

Area of Science:

• Gastroenterology
• Hematology
• Transplantation Medicine

Background:

• Allogeneic transplantation involves conditioning regimens and potential complications like graft-versus-host disease (GVHD).
• Intestinal function can be affected post-transplant, impacting nutrient absorption.
• Vitamin B12 absorption is a key indicator of ileal function.

Purpose of the Study:

• To evaluate ileal vitamin B12 absorption using the Schilling test in patients post-allogeneic transplantation.
• To assess the impact of acute and chronic graft-versus-host disease (GVHD) on vitamin B12 absorption.
• To determine the utility of the B12 absorption test as a non-invasive measure of bowel function after bone marrow transplantation.

Main Methods:

• Utilized the vitamin B12 absorption test (Schilling test) with intrinsic factor.
• Studied 26 patients following allogeneic transplantation.
• Compared B12 absorption in patients with and without chronic GVHD.

Main Results:

• Vitamin B12 absorption significantly decreased post-transplantation, peaking at two weeks and recovering by eight weeks.
• Acute GVHD did not appear to further impair B12 absorption.
• Chronic GVHD was associated with a significant reduction (p < 0.005) in B12 absorption compared to patients without GVHD.

Conclusions:

• The B12 absorption test is a well-tolerated, non-invasive method for assessing ileal function post-bone marrow transplant.
• Chronic GVHD significantly impairs vitamin B12 absorption, suggesting its utility in monitoring transplant complications.
• The conditioning regimen appears to be the primary factor influencing early B12 absorption post-transplant.