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Low 25(OH) vitamin D 3 levels are associated with adverse outcome in newly diagnosed, intensively treated adult acute myeloid leukemia
Author(s) -
Lee Hun Ju,
Muindi Josephia R.,
Tan Wei,
Hu Qiang,
Wang Dan,
Liu Song,
Wilding Gregory E.,
Ford Laurie A.,
Sait Sheila N. J.,
Block Annemarie W.,
Adjei Araba A.,
Barcos Maurice,
Griffiths Elizabeth A.,
Thompson James E,
Wang Eunice S.,
Johnson Candace S.,
Trump Donald L.,
Wetzler Meir
Publication year - 2013
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.28368
Subject(s) - medicine , vitamin d and neurology , myeloid leukemia , gastroenterology , single nucleotide polymorphism , vitamin , calcitriol receptor , genotype , biology , gene , biochemistry
BACKGROUND Several studies have suggested that low 25(OH) vitamin D 3 levels may be prognostic in some malignancies, but no studies have evaluated their impact on treatment outcome in patients with acute myeloid leukemia (AML). METHODS Vitamin D levels were evaluated in 97 consecutive, newly diagnosed, intensively treated patients with AML. MicroRNA expression profiles and single nucleotide polymorphisms (SNPs) in the 25(OH) vitamin D 3 pathway genes were evaluated and correlated with 25(OH) vitamin D 3 levels and treatment outcome. RESULTS Thirty‐four patients (35%) had normal 25(OH) vitamin D 3 levels (32‐100 ng/mL), 34 patients (35%) had insufficient levels (20‐31.9 ng/mL), and 29 patients (30%) had deficient levels (<20 ng/mL). Insufficient/deficient 25(OH) vitamin D 3 levels were associated with worse relapse‐free survival (RFS) compared with normal vitamin D 3 levels. In multivariate analyses, deficient 25(OH) vitamin D 3 , smoking, European Leukemia Network genetic group, and white blood cell count retained their statistical significance for RFS. Several microRNAs and SNPs were associated with 25(OH) vitamin D 3 levels, although none remained significant after multiple test corrections; one 25(OH) vitamin D 3 receptor SNP, rs10783219, was associated with a lower complete remission rate ( P = .0442) and with shorter RFS ( P = .0058) and overall survival ( P = .0011). CONCLUSIONS It remains to be determined what role microRNA and SNP profiles play in contributing to low 25(OH) vitamin D 3 level and/or outcome and whether supplementation will improve outcomes for patients with AML. Cancer 2014;120:521–529 . © 2013 American Cancer Society .