Journal article
Vitamin D insufficiency and prognosis in chronic lymphocytic leukemia
Blood, Vol.117(5), pp.1492-1498
Clinical Trials and Observations
02/03/2011
DOI: 10.1182/blood-2010-07-295683
PMCID: PMC3056589
PMID: 21048153
Abstract
Vitamin D insufficiency is common globally and low levels are linked to higher cancer incidence. Although vitamin D insufficiency is related to inferior prognosis in some cancers, no data exist for chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). We evaluated the relationship of 25(OH)D serum levels with time-to-treatment (TTT) and overall survival (OS) in newly diagnosed CLL patients participating in a prospective cohort study (discovery cohort) and a separate cohort of previously untreated patients participating in an observational study (confirmation cohort). Of 390 CLL patients in the discovery cohort, 119 (30.5%) were 25(OH)D insufficient. After a median follow-up of 3 years, TTT (hazard ratio[HR] = 1.66;
P
= .005) and OS (HR = 2.39;
P
= .01) were shorter for 25(OH)D-insufficient patients. In the validation cohort, 61 of 153 patients (39.9%) were 25(OH)D insufficient. After a median follow-up of 9.9 years, TTT (HR = 1.59;
P
= .05) and OS (HR 1.63;
P
= .06) were again shorter for 25(OH)D-insufficient patients. On pooled multivariable analysis of patients in both cohorts adjusting for age, sex, Rai stage, CD38 status, ZAP-70 status, immunoglobulin heavy chain variable (IGHV) gene mutation status, CD49d status, and cytogenetic abnormalities assessed by interphase fluorescent in situ hybridization testing, 25(OH)D insufficiency remained an independent predictor of TTT (HR = 1.47;
P
= .008), although the association with OS was not significant (HR = 1.47;
P
= .07). Vitamin D insufficiency is associated with inferior TTT and OS in CLL patients. Whether normalizing vitamin D levels in deficient CLL patients would improve outcome merits clinical testing.
Details
- Title: Subtitle
- Vitamin D insufficiency and prognosis in chronic lymphocytic leukemia
- Creators
- Tait D Shanafelt - Division of HematologyMatthew T Drake - Division of Endocrinology, Department of Internal Medicine, andMatthew J Maurer - Division of Biomedical Statistics & Informatics, Mayo Clinic, Rochester, MNCristine Allmer - Division of Biomedical Statistics & Informatics, Mayo Clinic, Rochester, MNKari G Rabe - Division of Biomedical Statistics & Informatics, Mayo Clinic, Rochester, MNSusan L Slager - Division of Biomedical Statistics & Informatics, Mayo Clinic, Rochester, MNGeorge J Weiner - Division of Hematology, Oncology, and Blood & Marrow Transplantation, Department of Internal Medicine, College of Medicine, University of Iowa, Iowa City, IA; andTimothy G Call - Division of HematologyBrian K Link - Division of Hematology, Oncology, and Blood & Marrow Transplantation, Department of Internal Medicine, College of Medicine, University of Iowa, Iowa City, IA; andClive S Zent - Division of HematologyNeil E Kay - Division of HematologyCurtis A Hanson - Department of Pathology andThomas E Witzig - Division of HematologyJames R Cerhan - Division of Epidemiology, Mayo Clinic, Rochester, MN
- Resource Type
- Journal article
- Publication Details
- Blood, Vol.117(5), pp.1492-1498
- Publisher
- American Society of Hematology
- Series
- Clinical Trials and Observations
- DOI
- 10.1182/blood-2010-07-295683
- PMID
- 21048153
- PMCID
- PMC3056589
- ISSN
- 0006-4971
- eISSN
- 1528-0020
- Grant note
- P50 CA97274; CA 113408 / National Institutes of Health
- Language
- English
- Date published
- 02/03/2011
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Pharmaceutical Sciences and Experimental Therapeutics; Internal Medicine
- Record Identifier
- 9984094546402771
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