Vitamin D insufficiency predicts time to first treatment (TFT) in early chronic lymphocytic leukemia (CLL)
Leukemia Research doi:10.1016/j.leukres.2011.10.004 |
Stefano Molicaa, , , Giovanna Digiesib, Anna Antenuccib, Luciano Levatoa, Rosanna Mirabellia, Matteo Molicaa, Massimo Gentilec, Diana Giannarellid, Isabella Sperdutid, Fortunato Morabitoc, Laura Contib
a Dipartimento di Emato-oncologia, Azienda Ospedaliera di Catanzaro, Catanzaro, Italy
b Servizio di Patologia Clinica, IRCCS Regina Elena, SAFU, Rome, Italy
c U.O.C. di Ematologia, Azienda Ospedaliera Annunziata di Cosenza, Cosenza, Italy
d Servizio di Biostatistica, IRCCS Regina Elena, Rome, Italy
Received 24 July 2011; revised 1 September 2011; Accepted 7 October 2011. Available online 1 November 2011.
Although vitamin D insufficiency is related to inferior prognosis in some cancers, limited data exist in hematologic malignancies. We evaluated the relationship between 25(OH)D serum levels and time to first treatment (TFT), a disease-specific end point, in 130 previously untreated Binet stage A chronic lymphocytic leukemia (CLL) patients. Measurement of 25(OH)D was performed by means of a direct, competitive chemiluminescence immunoassay using the DiaSorin LIAISON 25(OH)D TOTAL assay (DiaSorin, Inc., Stillwater, Minnesota).
Overall, 41 patients (31.5%) had severe vitamin D insufficiency (<10 ng/mL), 66 (50.7%) had mild to moderate insufficiency (10–24 ng/mL), and 23 (17.6%) had 25(OH)D levels within the optimal range (25–80 ng/mL), with no relationship with between the season of sample collection and 25(OH)D level (P = 0.188). A patient stratification according to these 3 groups led to significant difference in terms of TFT, with vitamin D insufficient patients having the shortest TFT (P = 0.02). With respect to continuous 25(OH)D levels and clinical outcome, TFT was shorter as 25(OH)D decreased until a value of 13.5 ng/mL at which point the association of 25(OH)D and TFT remained constant. As a matter of fact, the 25(OH)D value of 13.5 ng/mL identified two patients subsets with different TFT risk (HR = 1.91; 95% CI = 1.06–3.44; P = 0.03). In multivariate analysis the variable entering the model at a significant level were mutational status of IgVH (P < 0.0001), serum thymidine kinase (P = 0.02) and absolute lymphocyte count (P = 0.03). Thus confirming the Mayo clinic experience, our data provide further evidence that 25(OH)D levels may be an important host factor influencing TFT of Binet stage A patients. Whether normalizing vitamin D levels may delay disease-progression of patients with early disease will require testing in future trials.
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Perhaps the people would have been far less likely to have gotten the Cancer in the first place if they previously had a high level of vitamin D
- All items in Vitamin D after Cancer Diagnosis 20 items as of Nov 2011
- Overview Cancer and vitamin D which has many graphs, such as the following one