Prognostic Value of 25‑Hydroxy Vitamin D in Extranodal NK/T Cell Lymphoma

Abstract

<jats:title>Abstract</jats:title> <jats:p>Background 25-hydroxy vitamin D [25-(OH)D] is widely used to determine vitamin D status in clinic. The aim of our study was to evaluate the prognostic value of 25-(OH)D in extranodal NK/T cell lymphoma (ENKTL). Materials and Methods Ninety-three ENKTL patients with available serum 25-(OH)D values were enrolled in our study. Vitamin D deficiency is defined as a 25-(OH)D below 50 nmol/L. Univariate and multivariate regression analyses were performed to determine independent risk factors for progression-free survival (PFS) and overall survival (OS). Subgroup analyses were performed to determine the applicable subgroups. Receiver operator characteristic (ROC) curves were plotted to estimate the accuracy of PINK-E (prognostic index of natural killer lymphoma added with Epstein-Barr virus-DNA status) and 25-(OH)D deficiency in ENKTL risk-stratification. Results Our results suggested that vitamin D deficiency was an independent inferior prognostic factor for both PFS [hazard ratio (HR), 2.869; 95% confidence interval (CI), 1.540 to 5.346; <jats:italic>P</jats:italic> = 0.003] and OS (HR, 3.204; 95%CI, 1.559 to 6.583; <jats:italic>P</jats:italic> = 0.006) in ENKTL patients with age ≤ 60, ECOG PS ≤ 1, stage III‒IV and PINK-E score ≥ 3. Additionally, we demonstrated that adding 25-(OH)D deficiency to PINK-E score system indeed has a superior prognostic significance than PINK-E alone for PFS [AUC: 0.796 (95% CI: 0.699 to 0.872) vs. 0.759 (95% CI: 0.659 to 0.841), <jats:italic>P</jats:italic> = 0.020] and OS [AUC: 0.755 (95% CI: 0.655 to 0.838) vs. 0.721 (95% CI: 0.618 to 0.809), <jats:italic>P</jats:italic> = 0.040]. Conclusion In conclusion, our study proved that 25-(OH)D deficiency was associated with inferior survival outcomes of ENKTL patients.</jats:p>

The Novel Prognostic Index Model of Combining Circulating Tumor DNA and PINK-E Predicts the Clinical Outcomes for Newly Diagnosed Extranodal NK/T-cell Lymphoma

“…Apart from these traditional scoring models, some other biomarkers were also used for ENKTL, for example, 25-hydroxy vitamin D, 46 prognostic nutritional index, 47,48 C-reactive protein to albumin ratio (CAR), 49 and maximum standardized uptake value (SUVmax). 33 ctDNA analysis has increased sensitivity and specificity compared with the analysis of other circulating biomarkers and SUVmax.…”