DOI QR코드

DOI QR Code

Serum 25-hydroxyvitamin D Insufficiency in B-Chronic Lymphoid Leukemia at the Time of Disease Presentation in Pakistan

  • Parveen, Saira (Hematology Department, Liaquat National Hospital and Medical College) ;
  • Zeeshan, Rozina (Hematology Department, Liaquat National Hospital and Medical College) ;
  • Sultan, Sadia (Hematology Department, Liaquat National Hospital and Medical College) ;
  • Irfan, Syed Mohammad (Hematology Department, Liaquat National Hospital and Medical College)
  • Published : 2015.09.02

Abstract

Background: Serum 25-hydroxyvitamin D insufficiency is very common in Pakistan and is often related to inferior prognosis in some cancers but limited data exist for hematopoietic malignancies. This study was conducted to determine the vitamin D insufficiency in B-chronic lymphoid leukemia (CLL) cases at the time of presentation and its possible correlation with clinical staging, hematological parameters and biochemical markers. Materials and Methods: This descriptive cross sectional study was carried at Liaquat National Hospital from January 2011 to June 2013. Sixty patients with B-chronic lymphoid leukemia were enrolled. Complete blood count, vitamin D levels, serum urea, creatinine, uric acid and LDH levels were assessed. Data were compiled and analyzed using SPSS version 21. Results: Out of 60 patients, 42 (70%) were male and 18 (30%) were female. Mean age was $59.0{\pm}9.2years$. The frequency of vitamin D insufficiency was found to be 56.7%. Overall insufficiency was more frequently seen in male gender (40%). Vitamin D insufficiency demonstrated a positive association with low lactate dehydrogenase levels (P=0.005). No links were established with age, clinical stage, hematological and other biochemical markers. Conclusions: Vitamin D insufficiency is high compared with Western studies. Whether normalization of vitamin D insufficiency in deficient B-CLL patients could improve the clinical outcome or delay disease progression will require further studies.

Keywords

References

  1. Aref S, Ibrahim L, Azmy E (2013). Prognostic impact of serum 25-hydroxivitamin D [25(OH)D] concentrations in patients with lymphoid malignancies. Hematol, 18, 20-5. https://doi.org/10.1179/1607845412Y.0000000025
  2. Arlet JB, Callens C, Hermine O, et al (2012). Chronic lymphocytic leukaemia responsive to vitamin D administration. Br J Haematol, 156, 148-9. https://doi.org/10.1111/j.1365-2141.2011.08828.x
  3. Chen P, Hu P, Xie D, et al (2010). Meta-analysis of vitamin D, calcium and the prevention of breast cancer. Breast Cancer Res Treat, 121, 469-77. https://doi.org/10.1007/s10549-009-0593-9
  4. Feldman D, Krishnan AV, Swami S, Giovannucci E, Feldman BJ (2014). The role of vitamin D in reducing cancer risk and progression. Nat Rev Cancer, 14, 342-57. https://doi.org/10.1038/nrc3691
  5. Garland CF, Gorham ED, Mohr SB, Garland FC. (2009). Vitamin D for cancer prevention: global perspective. Ann Epidemiol, 19, 468-83. https://doi.org/10.1016/j.annepidem.2009.03.021
  6. Holick MF (2007). Vitamin D deficiency. N Engl J Med, 357, 266-81. https://doi.org/10.1056/NEJMra070553
  7. Li ZJ, Qiu LG, Wu T, et al (2008). The clinical and laboratory features of 263 cases of chronic lymphocytic leukemia. Zhonghua Xue Ye Xue Za Zhi, 29, 300-3
  8. Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP (2007). Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr, 85, 1586-91.
  9. Luczynska A, Kaaks R, Rohrmann S, et al (2013). Plasma 25-hydroxyvitamin D concentration and lymphoma risk: results of the European Prospective Investigation into Cancer and Nutrition. Am J Clin Nutr, 98, 827-38. https://doi.org/10.3945/ajcn.112.054676
  10. Mauro FR, Foa R, Giannarelli D, et al (1999). Clinical characteristics and outcome of young chronic lymphocytic leukemia patients: a single institution study of 204 cases. Blood, 94, 448-54.
  11. Molica S, Digiesi G, Antenucci A, et al (2012). Vitamin D insufficiency predicts time to first treatment (TFT) in early chronic lymphocytic leukemia (CLL). Leuk Res, 36, 443-7. https://doi.org/10.1016/j.leukres.2011.10.004
  12. Mozaheb Z, Hasanzadeh N, Abadi MH, Aghaee MA (2012). Chronic lymphocytic leukemia and prognostic factors. Asian Pac J Cancer Prev, 13, 3009-13. https://doi.org/10.7314/APJCP.2012.13.7.3009
  13. Pepper C, Thomas A, Hoy T, et al (2003). The vitamin D3 analog EB1089 induces apoptosis via a p53-independent mechanism involving p38 MAP kinase activation and suppression of ERK activity in B-cell chronic lymphocytic leukemia cells in vitro. Blood, 101, 2454-60. https://doi.org/10.1182/blood-2002-07-1984
  14. Raina V, Cunningham D, Gilchrist N, Soukop M (1991). Alfacalcidol is a nontoxic, effective treatment of follicular small-cleaved cell lymphoma. Br J Cancer, 63, 463-5. https://doi.org/10.1038/bjc.1991.108
  15. Rozman C, Montserrat E (1995). Chronic lymphocytic leukemia. N Engl J Med, 1333, 1052-57.
  16. Sagatys EM, Zhang L (2012). Clinical and laboratory prognostic indicators in chronic lymphocytic leukemia. Cancer Control, 19, 18-25.
  17. Shanafelt TD, Drake MT, Maurer MJ, et al (2011). Vitamin D insufficiency and prognosis in chronic lymphocytic leukemia. Blood, 117, 1492-8. https://doi.org/10.1182/blood-2010-07-295683
  18. Thomas X, Chelghoum Y, Fanari N, Cannas G (2011). Serum 25-hydroxyvitamin D levels are associated with prognosis in hematological malignancies. Hematol, 16, 278-83. https://doi.org/10.1179/102453311X13085644679908
  19. Wang W, Li G, He X, et al (2015). Serum 25-hydroxyvitamin d levels and prognosis in hematological malignancies: a systematic review and meta-analysis. Cell Physiol Biochem, 35, 1999-2005. https://doi.org/10.1159/000374007
  20. Xu W, Li JY, Miao KR, et al (2009). The negative prognostic significance of positive direct antiglobulin test in Chinese patients with chronic lymphocytic leukemia. Leuk Lymphom, 50, 1482-7. https://doi.org/10.1080/10428190903111930
  21. Yin L, Grandi N, Raum E, et al (2009). Meta-analysis: longitudinal studies of serum vitamin D and colorectal cancer risk. Aliment Pharmacol Ther, 30, 113-25. https://doi.org/10.1111/j.1365-2036.2009.04022.x
  22. Zeeshan R, Sultan S, Irfan SM, Kakar J, Hameed MA (2015). Clinico-hematological profile of patients with B-chronic lymphoid leukemia in Pakistan. Asian Pac J Cancer Prev, 16, 793-6. https://doi.org/10.7314/APJCP.2015.16.2.793
  23. Zeeshan R, Irfan SM, Sultan S, Bhimani S (2015). ZAP-70 protein expression in B-cell Chronic Lymphoid Leukemia: A single center experience from Pakistan. Asian Pac J Cancer Prev, 16, 1587-90. https://doi.org/10.7314/APJCP.2015.16.4.1587
  24. Zwiebel JA, Cheson BD (1998). Chronic lymphocytic leukemia: staging and prognostic factors. Semin Oncol, 25, 42-59.