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Vitamin D deficiency and supplementation in patients with aggressive B-cell lymphomas treated with immunochemotherapy.
- Source :
- Cancer Medicine; Jan2018, Vol. 7 Issue 1, p270-281, 12p
- Publication Year :
- 2018
-
Abstract
- Vitamin D deficiency has been reported to be a negative prognostic factor in elderly patients with aggressive B- cell lymphomas. In vitro data suggest that vitamin D supplementation may enhance rituximab- mediated cytotoxicity. We prospectively assessed 25- hydroxyvitamin D [25(OH)D] levels at diagnosis in a cohort of 155 patients with aggressive B- cell lymphomas of whom 128 had diffuse large B- cell lymphoma (DLBCL) not otherwise specified. 25(OH)D levels were deficient (<20 ng/mL) in 105 (67%), insufficient (20--29 ng/mL) in 32 (21%), and normal (≥30 ng/mL) in 18 (12%) patients with a seasonal variation. Patient characteristics associated with lower 25(OH)D levels were poor performance status, overweight, B- symptoms, elevated LDH, lower albumin and hemoglobin levels. As a result of a change in practice pattern, 116 patients received vitamin D3 (cholecalciferol) supplementation that included a loading phase with daily replacement and subsequent maintenance phase with a weekly dose of 25,000 IU until end of treatment. This resulted in a significant increase in 25(OH)D levels, with normalization in 56% of patients. We analyzed the impact of 25(OH)D levels on event- free survival in patients treated with Rituximab- CHOP. 25(OH)D levels below 20 ng/mL at diagnosis and IPI were independently associated with inferior EFS. Moreover, patients with normalized 25(OH)D levels following supplementation showed better EFS than patients with persistently deficient/insufficient 25(OH)D levels. Our study provides the first evidence that achievement of normal 25(OH)D levels after vitamin D3 supplementation is associated with improved outcome in patients with DLBCL and deficient/insuf- ficient 25(OH)D levels when receiving rituximab- based treatment. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 20457634
- Volume :
- 7
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Cancer Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 127588765
- Full Text :
- https://doi.org/10.1002/cam4.1166