Impact of Vitamin D Deficiency on Relapse in Patients With Myeloid Malignancies

Patients with myeloid malignancies who have vitamin D deficiency before undergoing allogeneic stem cell transplantation (alloSCT) are at a higher risk of relapse, according to recent research published in the Journal of Clinical Oncology (online August 3, 2017; doi:10.1200/JCO.2017.73.0085).

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Vitamin D deficiency is often observed in patients with hematologic malignancies undergoing alloSCT. However, the prognostic indication of vitamin D deficiency in this population is unclear.

Thomas Luft, MD, PhD, University Hospital Heidelberg (Germany), and colleagues conducted a study to better understand the impact of pretransplant vitamin D status on overall survival, relapse mortality, and non-relapse mortality. Researchers analyzed outcomes of 492 patients in a training cohort and 398 patients in a validation cohort, all of whom had a myeloid or lymphoid malignancy, underwent alloSCT, and had confirmed records of pretransplant vitamin D levels.

A total of 396 patients (80%) and 348 patients (87%) demonstrated vitamin D deficiency before alloSCT in the training and validation cohort, respectively.

For patients in the training cohort, vitamin D deficiency was significantly associated with inferior overall survival (HR, 1.78; P = .007) in a multivariable analysis, due to a higher risk of relapse (HR, 1.96; P = .006). Patients with vitamin D deficiency were also at higher risk of non-relapse mortality (HR, 1.72; P = .088).

A significant association was observed for patients with myeloid malignancies and pre-transplant vitamin D deficiency with higher relapse rates (HR, 2.55; P = .014), but the same association was not found significant for patients with lymphatic diseases (HR, 1.60; P = .147).

The validation cohort further confirmed the impact of pre-transplant vitamin D deficiency on relapse risk in myeloid malignancies (HR, 2.60; P = .017).

Researchers concluded that pre-transplant vitamin D deficiency is significantly associated with a higher risk of relapse and subsequently inferior overall survival in patients allografted for myeloid malignancies. Further prospective studies on vitamin D status and intervention of vitamin D deficiency in an alloSCT setting are highly warranted, they wrote.—Zachary Bessette