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Vitamin D insufficiency is associated with an increased risk of early clinical failure in follicular lymphoma.
Blood Cancer J. 2017 Aug 25; 7(8):e595.BC

Abstract

We evaluated whether vitamin D insufficiency (VDI; 25(OH)D <20 ng/ml) was associated with adverse outcomes among follicular lymphoma (FL) patients using an observational prospective cohort study of 642 FL patients enrolled from 2002-2012. The median age at diagnosis was 60 years. At a median follow-up of 59 months, 297 patients (46%) had an event (progression, treatment failure), 78 had died and 42 (6.5%) had a lymphoma-related death. VDI was associated with inferior event-free survival (EFS) at 12 months (EFS12, odds ratio (OR)=2.05; 95% confidence interval (CI) 1.18-3.54), overall survival (OS, hazards ratio (HR)=2.35; 95%CI 1.37-4.02), and lymphoma-specific survival (LSS, HR=2.97; 95% CI 1.52-5.80) for the full cohort. Among patients treated with immunochemotherapy (IC), VDI was associated with inferior EFS12 (OR=3.00; 95% CI 1.26-7.13), OS (HR=2.86; 95% CI 1.39-5.85), and LSS (HR=2.96; 95% CI 1.29-6.79). For observed patients, VDI was associated with inferior OS (HR=2.85; 95% CI 1.20-6.76). For other therapies, VDI was associated with inferior OS (HR=3.06; 95% CI 1.01-9.24). Our work is the first to reveal an association of VDI with early clinical failure, and to demonstrate an association of VDI with adverse outcomes among patients who are observed or treated with therapies other than IC. Our findings suggest a potentially modifiable prognostic factor to address in patients with FL.

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Authors+Show Affiliations

Tracy SI
Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Maurer MJ
Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Witzig TE
Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Drake MT
Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Ansell SM
Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Nowakowski GS
Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Thompson CA
Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Inwards DJ
Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Johnston PB
Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Micallef IN
Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Allmer C
Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Macon WR
Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Weiner GJ
Division of Hematology Oncology and Blood and Marrow Transplantation, Department of Internal Medicine, University of Iowa, Iowa City, IA, USA.
Slager SL
Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Habermann TM
Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Link BK
Division of Hematology Oncology and Blood and Marrow Transplantation, Department of Internal Medicine, University of Iowa, Iowa City, IA, USA.
Cerhan JR
Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.

MeSH

AdultAgedAged, 80 and overDisease-Free SurvivalFemaleHumansLymphoma, FollicularMaleMiddle AgedRisk FactorsSurvival RateVitamin D Deficiency

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28841207

Clinical Trial Links

Towards Personalized Medicine for Refractory/Relapsed Follicular Lymphoma Patients: the Cantera/Lupiae Registry

Citation

Tracy, S I., et al. "Vitamin D Insufficiency Is Associated With an Increased Risk of Early Clinical Failure in Follicular Lymphoma." Blood Cancer Journal, vol. 7, no. 8, 2017, pp. e595.
Tracy SI, Maurer MJ, Witzig TE, et al. Vitamin D insufficiency is associated with an increased risk of early clinical failure in follicular lymphoma. Blood Cancer J. 2017;7(8):e595.
Tracy, S. I., Maurer, M. J., Witzig, T. E., Drake, M. T., Ansell, S. M., Nowakowski, G. S., Thompson, C. A., Inwards, D. J., Johnston, P. B., Micallef, I. N., Allmer, C., Macon, W. R., Weiner, G. J., Slager, S. L., Habermann, T. M., Link, B. K., & Cerhan, J. R. (2017). Vitamin D insufficiency is associated with an increased risk of early clinical failure in follicular lymphoma. Blood Cancer Journal, 7(8), e595. https://doi.org/10.1038/bcj.2017.70
Tracy SI, et al. Vitamin D Insufficiency Is Associated With an Increased Risk of Early Clinical Failure in Follicular Lymphoma. Blood Cancer J. 2017 08 25;7(8):e595. PubMed PMID: 28841207.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin D insufficiency is associated with an increased risk of early clinical failure in follicular lymphoma. AU - Tracy,S I, AU - Maurer,M J, AU - Witzig,T E, AU - Drake,M T, AU - Ansell,S M, AU - Nowakowski,G S, AU - Thompson,C A, AU - Inwards,D J, AU - Johnston,P B, AU - Micallef,I N, AU - Allmer,C, AU - Macon,W R, AU - Weiner,G J, AU - Slager,S L, AU - Habermann,T M, AU - Link,B K, AU - Cerhan,J R, Y1 - 2017/08/25/ PY - 2016/12/22/received PY - 2017/05/02/revised PY - 2017/05/08/accepted PY - 2017/8/26/entrez PY - 2017/8/26/pubmed PY - 2018/8/30/medline SP - e595 EP - e595 JF - Blood cancer journal JO - Blood Cancer J VL - 7 IS - 8 N2 - We evaluated whether vitamin D insufficiency (VDI; 25(OH)D <20 ng/ml) was associated with adverse outcomes among follicular lymphoma (FL) patients using an observational prospective cohort study of 642 FL patients enrolled from 2002-2012. The median age at diagnosis was 60 years. At a median follow-up of 59 months, 297 patients (46%) had an event (progression, treatment failure), 78 had died and 42 (6.5%) had a lymphoma-related death. VDI was associated with inferior event-free survival (EFS) at 12 months (EFS12, odds ratio (OR)=2.05; 95% confidence interval (CI) 1.18-3.54), overall survival (OS, hazards ratio (HR)=2.35; 95%CI 1.37-4.02), and lymphoma-specific survival (LSS, HR=2.97; 95% CI 1.52-5.80) for the full cohort. Among patients treated with immunochemotherapy (IC), VDI was associated with inferior EFS12 (OR=3.00; 95% CI 1.26-7.13), OS (HR=2.86; 95% CI 1.39-5.85), and LSS (HR=2.96; 95% CI 1.29-6.79). For observed patients, VDI was associated with inferior OS (HR=2.85; 95% CI 1.20-6.76). For other therapies, VDI was associated with inferior OS (HR=3.06; 95% CI 1.01-9.24). Our work is the first to reveal an association of VDI with early clinical failure, and to demonstrate an association of VDI with adverse outcomes among patients who are observed or treated with therapies other than IC. Our findings suggest a potentially modifiable prognostic factor to address in patients with FL. SN - 2044-5385 UR - https://www.unboundmedicine.com/medline/citation/28841207/full_citation DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓17 ↑17]

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