Folate and Vitamin B12 Status in Pediatric Hematopoietic Stem Cell Transplantation Patients.

BACKGROUND/

OBJECTIVES

Vitamin B12 and folic acid (FA) are crucial for children's hematopoiesis after hematopoietic stem cell transplantation (HSCT). This study evaluates the B12 and FA level changes before and after HSCT.

METHODS

We retrospectively collected data from 125 patients who underwent HSCT between March 2019 and February 2024. B12 and FA levels were measured at three time points: before transplantation, one month after, and six months after. Sixty-two patients had complete data. B12 deficiency was defined as levels < 200 pg/mL and insufficiency as 200-300 pg/mL. Folate deficiency was classified as insufficiency ≤ 3 ng/mL, indeterminate for 4.0-5.8 ng/mL and typical for 5.9-26.8 ng/mL. Patients with B12 < 300 pg/mL and folic acid < 5 ng/mL were treated at all stages.

RESULTS

Among the 62 patients, 24 (38.7%) were girls, with a median age of 4 years (1.75-8.25). Median B12 levels were 398 pg/mL (pre-transplant), 892 pg/mL (1 month post), and 430 pg/mL (6 months post). The second time point had significantly higher B12 levels (p < 0.001). Median folate levels were 9.7 ng/mL, 6.95 ng/mL, and 11.3 ng/mL at the respective time points (p < 0.05), with the second time point significantly lower.

CONCLUSIONS

Pediatric HSCT patients experience increased demands for B12 and FA despite accurate treatment, leading to potential deficiencies. Close monitoring, early supplementation, and supplementing high levels of these micronutrients are essential.