Document Detail


Vitamin D insufficiency and prognosis in chronic lymphocytic leukemia.
MedLine Citation:
PMID:  21048153     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Tait D Shanafelt; Matthew T 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 E Kay; Curtis A Hanson; Thomas E Witzig; James R Cerhan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-11-03
Journal Detail:
Title:  Blood     Volume:  117     ISSN:  1528-0020     ISO Abbreviation:  Blood     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-04     Completed Date:  2011-04-14     Revised Date:  2012-02-03    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1492-8     Citation Subset:  AIM; IM    
Affiliation:
Division of Hematology, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antigens, CD38 / metabolism
Chromatography, Liquid
Cohort Studies
Female
Humans
In Situ Hybridization, Fluorescence
Leukemia, Lymphocytic, Chronic, B-Cell / blood*,  drug therapy,  mortality
Male
Middle Aged
Prognosis
Prospective Studies
Survival Rate
Tandem Mass Spectrometry
Tumor Markers, Biological / blood*
Vitamin D / analogs & derivatives*,  blood
Vitamin D Deficiency / blood*,  drug therapy,  mortality
ZAP-70 Protein-Tyrosine Kinase / genetics
Grant Support
ID/Acronym/Agency:
CA 113408/CA/NCI NIH HHS; P50 CA97274/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Tumor Markers, Biological; 1406-16-2/Vitamin D; 64719-49-9/25-hydroxyvitamin D; EC 2.7.1.112/ZAP70 protein, human; EC 2.7.10.2/ZAP-70 Protein-Tyrosine Kinase; EC 3.2.2.5/Antigens, CD38
Comments/Corrections
Comment In:
Blood. 2011 Feb 3;117(5):1439-40   [PMID:  21292782 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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