Vitamin D insufficiency and prognosis in chronic lymphocytic leukemia (CLL).

[Guest guest]

That the association between low serum Vitamin D and poorer prognosis was

not significant as an *independent* factor suggests to me that it will prove

to be a marker of CLL risk rather than a useful intervention ... but I

assume that patients will not want to take that chance and will lobby for

vitamin D serum testing and remediation - hopefully under a doctor's

supervision given the risk of high vitamin D in lymphoma - contributing to

the risk of hypercalcemia.

Karl

==

Blood. 2010 Nov 3.

Vitamin D insufficiency and prognosis in chronic lymphocytic leukemia (CLL).

Shanafelt TD, Drake MT, Maurer MJ, Allmer C, Rabe KG, Slager SL, Weiner GJ,

Call TG, Link BK, Zent CS, Kay NE, Hanson CA, Witzig TE, Cerhan JR.

Division of Hematology, Department of Internal Medicine, Mayo Clinic,

Rochester, MN, United States;

Abstract

" Vitamin D insufficiency is common globally with low levels 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).

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 median follow-up of 3 years, TTT(hazard ratio

---

=1.66; p=0.005) and

OS(HR=2.39; p=0.01) were shorter for 25(OH)D insufficient patients. In the

validation cohort, 61 of 153 patients(39.9%) were 25(OH)D insufficient.

After median follow-up of 9.9 years, TTT(HR=1.59; p=0.05) and OS(HR 1.63;

p=0.06) were again shorter for 25(OH)D insufficient patients.

On pooled multivariable analysis of patients in both cohorts adjusting for

age, sex, stage, CD38, ZAP-70, IGHV, CD49d, and FISH, 25(OH)D insufficiency

remained an independent predictor of TTT(HR=1.47; p=0.008), although the

association with OS was not significant(HR=1.47; p=0.07). 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. "

http://www.ncbi.nlm.nih.gov/pubmed/21048153