Vitamin D insufficiency and prognosis in chronic lymphocytic leukemia

Tait D. Shanafelt, Matthew M Drake, Matthew J. Maurer, Cristine Allmer, Kari G. Rabe, Susan L Slager, George J. Weiner, Timothy G. Call, Brian K. Link, Clive S. Zent, Neil Elliot Kay, Curtis A. Hanson, Thomas Elmer Witzig, James R Cerhan

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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.

Original languageEnglish (US)
Pages (from-to)1492-1498
Number of pages7
JournalBlood
Volume117
Issue number5
DOIs
StatePublished - Feb 3 2011

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B-Cell Chronic Lymphocytic Leukemia
Vitamin D
Hazards
Survival
Immunoglobulin Heavy Chains
Testing
Immunoglobulin Heavy Chain Genes
Therapeutics
Genes
Interphase
Fluorescence In Situ Hybridization
Chromosome Aberrations
Observational Studies
Neoplasms
Cohort Studies
Prospective Studies
Mutation
Incidence
Serum

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

Cite this

Vitamin D insufficiency and prognosis in chronic lymphocytic leukemia. / Shanafelt, Tait D.; Drake, Matthew M; Maurer, Matthew J.; Allmer, Cristine; Rabe, Kari G.; Slager, Susan L; Weiner, George J.; Call, Timothy G.; Link, Brian K.; Zent, Clive S.; Kay, Neil Elliot; Hanson, Curtis A.; Witzig, Thomas Elmer; Cerhan, James R.

In: Blood, Vol. 117, No. 5, 03.02.2011, p. 1492-1498.

Research output: Contribution to journalArticle

Shanafelt, TD, Drake, MM, Maurer, MJ, Allmer, C, Rabe, KG, Slager, SL, Weiner, GJ, Call, TG, Link, BK, Zent, CS, Kay, NE, Hanson, CA, Witzig, TE & Cerhan, JR 2011, 'Vitamin D insufficiency and prognosis in chronic lymphocytic leukemia', Blood, vol. 117, no. 5, pp. 1492-1498. https://doi.org/10.1182/blood-2010-07-295683
Shanafelt, Tait D. ; Drake, Matthew M ; Maurer, Matthew J. ; Allmer, Cristine ; Rabe, Kari G. ; Slager, Susan L ; Weiner, George J. ; Call, Timothy G. ; Link, Brian K. ; Zent, Clive S. ; Kay, Neil Elliot ; Hanson, Curtis A. ; Witzig, Thomas Elmer ; Cerhan, James R. / Vitamin D insufficiency and prognosis in chronic lymphocytic leukemia. In: Blood. 2011 ; Vol. 117, No. 5. pp. 1492-1498.
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AU - Slager, Susan L

AU - Weiner, George J.

AU - Call, Timothy G.

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AU - Kay, Neil Elliot

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