Impact of vitamin D level at diagnosis and transplantation on the prognosis of hematological malignancy: a meta-analysis

Ito, Yusuke; Honda, Akira; Kurokawa, Mineo

doi:10.1182/bloodadvances.2021004958

Cited by 18 publications

(14 citation statements)

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“…Concordantly with the association between low vitamin D status and poorer overall survival and progression-free survival in myeloid and lymphoid malignancies [ 161 ], in several types of leukemic cells, 1,25-(OH) 2 D 3 regulates essential pathways for survival and proliferation such as TLR, STAT1/3 or PI3K/AKT that are induced by immune cell–cell or cytokine activation [ 162 , 163 ].…”

Section: Mechanisms Introductionmentioning

confidence: 95%

Vitamin D and Cancer: An Historical Overview of the Epidemiology and Mechanisms

2022

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This is a narrative review of the evidence supporting vitamin D’s anticancer actions. The first section reviews the findings from ecological studies of cancer with respect to indices of solar radiation, which found a reduced risk of incidence and mortality for approximately 23 types of cancer. Meta-analyses of observational studies reported the inverse correlations of serum 25-hydroxyvitamin D [25(OH)D] with the incidence of 12 types of cancer. Case-control studies with a 25(OH)D concentration measured near the time of cancer diagnosis are stronger than nested case-control and cohort studies as long follow-up times reduce the correlations due to changes in 25(OH)D with time. There is no evidence that undiagnosed cancer reduces 25(OH)D concentrations unless the cancer is at a very advanced stage. Meta-analyses of cancer incidence with respect to dietary intake have had limited success due to the low amount of vitamin D in most diets. An analysis of 25(OH)D-cancer incidence rates suggests that achieving 80 ng/mL vs. 10 ng/mL would reduce cancer incidence rates by 70 ± 10%. Clinical trials have provided limited support for the UVB-vitamin D-cancer hypothesis due to poor design and execution. In recent decades, many experimental studies in cultured cells and animal models have described a wide range of anticancer effects of vitamin D compounds. This paper will review studies showing the inhibition of tumor cell proliferation, dedifferentiation, and invasion together with the sensitization to proapoptotic agents. Moreover, 1,25-(OH)2D3 and other vitamin D receptor agonists modulate the biology of several types of stromal cells such as fibroblasts, endothelial and immune cells in a way that interferes the apparition of metastases. In sum, the available mechanistic data support the global protective action of vitamin D against several important types of cancer.

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Section: Mechanisms Introductionmentioning

confidence: 95%

Vitamin D and Cancer: An Historical Overview of the Epidemiology and Mechanisms

2022

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“…There was a study showing vitamin D deficiency in NDMM is unrelated to survival or cytogenetics ( 12 ). Contrary to this, another clinical observation found that vitamin D deficiency corelated to poor overall survival in white NDMM patients, rather than African American patients, implying vitamin D status and its clinical relevance in MM are strongly influenced by racial differences ( 9 , 12 ) 。 As vitamin D signaling has a key regulatory role in maintaining a healthy immune system, controlling cell proliferation, differentiation and growth, and inhibiting angiogenesis ( 8 ), keep clarifying the significance of vitamin D deficiency in myeloma development is undoubtedly needed.…”

Section: Introductionmentioning

confidence: 99%

“…Recent clinical studies have revealed a consistent and strong association between vitamin D status and tumor progression and survival in several solid tumor ( 7 ). Vitamin D deficiency is extremely common in patients with multiple myeloma (MM), however, data on the association between vitamin D status and clinical outcomes of newly diagnosed multiple myeloma (NDMM) are rather inconsistent ( 8 – 12 ). There was a study showing vitamin D deficiency in NDMM is unrelated to survival or cytogenetics ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Vitamin D deficiency linked to abnormal bone and lipid metabolism predicts high-risk multiple myeloma with poorer prognosis

Bao¹,

Wang²,

Lu³

et al. 2023

Front. Endocrinol.

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PurposeVitamin D deficiency is frequent in patients with multiple myeloma (MM), however, its prognostic relevance in MM was rather inconclusive. We first investigated the association of vitamin D deficiency with abnormal bone and lipid metabolism in newly diagnosed multiple myeloma (NDMM), and next assessed the impact of serum ratio of vitamin D to carboxy-terminal telopeptide of type I collagen (β-CTX) on progression-free survival (PFS) and overall free survival (OS) in patients with NDMM.MethodsThe data of 431 consecutive patients with NDMM at Beijing Jishuitan Hospital from September 2013 to December 2022 were collected and retrospectively reviewed through our electronic medical record system. The measurement of 25-hydroxyvitamin D in the blood is an indicator of an individual’s overall vitamin D status.ResultsThe serum levels of vitamin D were negatively correlated with β-CTX in NDMM patients. Of note, positive correlation between vitamin D and cholesterol levels in the serum was found in this study. The cohort (n = 431) was divided into two groups based on the serum ratio of vitamin D to β-CTX. Compared to the group with a higher vitamin D to β-CTX ratio, the group with a lower vitamin D to β-CTX ratio (n = 257, 60%) exhibited hypocholesterolemia, inferior PFS and OS, along with increased cases of ISS stage-III and R-ISS stage-III, a higher number of plasma cells in the bone marrow, and elevated serum calcium levels. Consistent with this, multivariate analysis confirmed that the vitamin D to β-CTX ratio was an independent unfavorable indicator for survival in NDMM patients.ConclusionOur data demonstrated the ratio of vitamin D to β-CTX in the serum is a unique biomarker for NDMM patients to identify the high-risk cases with poor prognosis, which is superior to vitamin D itself for predicting PFS and OS in NDMM. Also, it is worth mentioning that our data on the connection between vitamin D deficiency and hypocholesterolemia might help clarify novel mechanistic aspects of myeloma development.

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“…In a meta-analysis, Ito et al [178] observed that lower vitamin D levels were associated with significantly poorer overall survival (HR: 1.50, 95%CI 1.03-2.18) and a higher relapse rate (HR: 2.12, 95%CI 1.41-3.19), while no significant impact on non-relapse mortality (NRM) was described (HR: 1.23, 95%CI 0.72-2.10).…”

Section: Vitamin D Levels: Impact On Allogenic Hsct Outcomesmentioning

confidence: 99%

Effect of Vitamin D on Graft-Versus-Host Disease

Rodríguez-Gil¹,

Carrillo‐Cruz²,

Marrero-Cepeda³

et al. 2022

Preprint

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The different cell subsets of the immune system express vitamin D receptor (VDR). Through VDR, vitamin D exerts different functions which influences on immune responses, as previously shown in different preclinical models. Based on this background, retrospective studies have explored the impact of vitamin D levels on the outcome of patients undergoing allogeneic hematopoietic stem cell transplantation, showing that vitamin D deficiency is related to an increased risk of complications, especially graft-versus-host disease. These results have been confirmed in a prospective cohorts trial, although further studies are required to confirm this data. In addition, the role of vitamin D on the treatment of hematologic malignancies has also been explored. Considering this dual effect both on the immune system as well as on tumor cells in patients with hematologic malignancies, vitamin D might be useful in this setting both to decrease graft-versus-host disease and relapse rates.

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Impact of vitamin D level at diagnosis and transplantation on the prognosis of hematological malignancy: a meta-analysis

Cited by 18 publications

References 85 publications

Vitamin D and Cancer: An Historical Overview of the Epidemiology and Mechanisms

Vitamin D and Cancer: An Historical Overview of the Epidemiology and Mechanisms

Vitamin D deficiency linked to abnormal bone and lipid metabolism predicts high-risk multiple myeloma with poorer prognosis

Effect of Vitamin D on Graft-Versus-Host Disease

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