Vitamin D Deficiency May Increase Relapse Risk Among Patients With Myeloid Malignancies
Patients with vitamin D deficiency had a higher risk of relapse; deficiency was also associated with a trend towards inferior survival.
Patients with myeloid malignancies who have vitamin D deficiency prior to allogeneic stem cell transplantation (alloSCT) have an increased risk of relapse, according to a study published in the Journal of Clinical Oncology.1
To determine the prognostic relevance of vitamin D deficiency in this setting, researchers analyzed the outcomes of 492 patients in a training cohort and 398 patients in a validation cohort. Eligible patients had a myeloid or lymphoid malignancy, underwent alloSCT, and had validated records of pre-transplant vitamin D levels.
Vitamin D deficiency was noted in 80% of patients in the training cohort and 87% of patients in the validation cohort prior to allograft. Median follow-up was 51.2 months.
Patients in the training cohort with vitamin D deficiency had a higher risk of relapse (hazard ratio [HR], 1.96; P = .006); deficiency was also associated with inferior overall survival (OS; HR, 1.78; P = .006).
Patients with vitamin D deficiency also trended higher towards an increased risk of non-relapse mortality (NRM) (HR, 1.72; P = .088).
Patients with myeloid malignancies who were vitamin D deficient prior to alloSCT exhibited worse outcomes for overall mortality and NRM, but only the risk of relapse was significant (HR, 2.55; P = .014).
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Vitamin D deficiency in patients with lymphoid malignancies was not associated with an increased risk of relapse, but was linked with a trend towards higher NRM (HR, 2.55; P = .078) and an inferior OS (HR, 2.06; P = .031).
In the validation cohort, there was not an increased risk for NRM, but there was an increased risk for relapse in pre-transplant vitamin D–deficient patients, though it did not negatively affect OS rates.
- Radujkovic A, Kordelas L, Krzykalla J, et al. Pretransplant vitamin D deficiency is associated with higher relapse rates in patients allografted for myeloid malignancies. J Clin Oncol. 2017 Aug 3. doi: 10.1200/JCO.2017.73.0085 [Epub ahead of print]