Prognostic significance of changes in serum transcobalamin levels in cancer patients with chemotherapy-induced granulocytopenia.

Serum transcobalamin (TC) levels were determined daily in 14 adults suffering from advanced nonhematological malignancies and hospitalized because of chemotherapy-induced leukopenia and fever. Even during the nadir leukocyte count, TCI and TCIII serum levels were normal or only slightly decreased indicating that bone marrow activity was not completely suppressed. A significant increase in serum TCII level was observed in all patients, with peak values occurring an average of 4.5 days from admission at a time when the median leukocyte count was 2,300/mm 3. Full white cell count recovery followed this peak TCII elevation within a mean of 5.5 days in all patients, coinciding with a fall in TCII levels to basal values. The rise in serum TCII level appears to be an early indicator for imminent bone marrow recovery in myelosuppressed patients.