Vitamin B12, folate and homocysteine levels in childhood acute lymphoblastic leukemia

INTRODUCTION: Acute lymphoblastic leukemia (ALL) is characterized by the excessive proliferation of immature lymphoid precursor cells within the hematopoietic system. Folate and vitamin B12 are key components of one-carbon metabolism and DNA methylation, processes essential for genomic stability.
METHODS: This retrospective study included children under 18 years of age with ALL who were followed at a single tertiary center between June 2015 and May 2021. Serum homocysteine, folate, and vitamin B12 levels were measured before chemotherapy initiation and compared with those of age- and sex-matched healthy controls. Patients were stratified into risk groups according to clinical characteristics.
RESULTS: A total of 104 patients were analyzed, 58.7% of whom were male. Compared with controls, children with ALL had significantly lower vitamin B12 and folate levels and higher homocysteine concentrations. Elevated homocysteine levels were associated with older age, T-cell ALL, and relapsed or refractory disease, while lower levels were observed in the low-risk group.
DISCUSSION AND CONCLUSION: In conclusion, altered vitamin B12, folate, and homocysteine profiles are associated with pediatric ALL, and homocysteine may serve as a potential diagnostic and prognostic biomarker.

Keywords: Acute lymphoblastic leukemia, children, vitamin B12, folate, homocysteine