Pretreatment Vitamin D deficiency is associated with impaired progression-free and overall survival in hodgkin lymphoma
Borchmann S, Cirillo M, Goergen H, Meder L, Sasse S, Kreissl S, Broeckelmann PJ, Von Tresckow B, Fuchs M, Ullrich RT, Engert A (2019)
Publication Type: Journal article
Publication year: 2019
Journal
Book Volume: 37
Pages Range: 3528-3537
Journal Issue: 36
DOI: 10.1200/JCO.19.00985
Abstract
PURPOSE Vitamin D deficiency is described as a modifiable risk factor for the incidence of and mortality in many common cancers; however, data in Hodgkin lymphoma (HL) are lacking. PATIENTS AND METHODS We thus performed a study measuring pretreatment Vitamin D levels in prospectively treated patients with HL and correlated this with clinical outcomes. A total of 351 patients from the German Hodgkin Study Group clinical trials (HD7, HD8, and HD9) were included. RESULTS Fifty percent of patients were Vitamin D deficient (, 30 nmol/L) before planned chemotherapy. Pretreatment Vitamin D deficiency was more common in relapsed/refractory patients than matched relapse-free controls (median baseline Vitamin D, 21.4 nmol/L v 35.5 nmol/L; proportion with Vitamin D deficiency, 68% v 41%; P <.001). Vitamin D-deficient patients had impaired progression-free survival (10-year difference, 17.6%; 95% CI, 6.9% to 28.4%; hazard ratio, 2.13; 95% CI, 1.84 to 2.48; P<001) and overall survival (10-year difference, 11.1%; 95% CI, 2.1% to 20.2%; hazard ratio, 1.82; 95% CI, 1.53 to 2.15; P <.001), consistent across trials and treatment groups. We demonstrated that Vitamin D status is an independent predictor of outcome and hypothesized that Vitamin D status might be important for the chemosensitivity of HL. We subsequently performed experiments supplementing physiologic doses of Vitamin D (calcitriol) to cultured HL cell lines and demonstrated increased antiproliferative effects in combination with chemotherapy. In an HLxenograft animal model, we showed that supplemental Vitamin D (dietary supplement, cholecalciferol) improves the chemosensitivity of tumors by reducing the rate of tumor growth compared with Vitamin D or chemotherapy alone. CONCLUSION On the basis of our clinical and preclinical findings, we encourage that Vitamin D screening and replacement be incorporated into future randomized clinical trials to properly clarify the role of Vitamin D replacement therapy in HL.
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Germany (DE)How to cite
APA:
Borchmann, S., Cirillo, M., Goergen, H., Meder, L., Sasse, S., Kreissl, S.,... Engert, A. (2019). Pretreatment Vitamin D deficiency is associated with impaired progression-free and overall survival in hodgkin lymphoma. Journal of Clinical Oncology, 37(36), 3528-3537. https://dx.doi.org/10.1200/JCO.19.00985
MLA:
Borchmann, Sven, et al. "Pretreatment Vitamin D deficiency is associated with impaired progression-free and overall survival in hodgkin lymphoma." Journal of Clinical Oncology 37.36 (2019): 3528-3537.
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