Vitamin D deficiency predicts for poor overall survival in white but not African American patients with multiple myeloma

Yellapragada, Sarvari Venkata; Fillmore, Nathanael; Frolov, Anna; Zhou, Yang; Dev, Pallavi; Yameen, Hassan; Ifeorah, Chizoba; Nhan, V.; Brophy, Mary; Munshi, Nikhil C.

doi:10.1182/bloodadvances.2019001411

Cited by 19 publications

(31 citation statements)

References 14 publications

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“…The literature search through PubMed, EMBASE, Cochrane Library databases, and three conference proceedings (ASH, ASCO, and EHA) identified 1212 articles after duplicates removed, of which 52 were considered relevant through the evaluation of titles and abstracts. Among them, 30 articles fulfilled the criteria for this meta-analysis: 5 articles on myeloid malignancies [17][18][19][20][21] , 20 on lymphoid malignancies 18,[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] , 3 on autologous HSCT (ASCT) [41][42][43] , and 3 on allo-HSCT [44][45][46] . A flow diagram of the article selection process is shown in Figure 1.…”

Section: Study Selectionmentioning

confidence: 99%

“…Seventh, for multiple myeloma (MM), only one article was included in our search 35 , which reported that lower vitamin D status was significantly associated with poor OS (HR: 1.34, p = 0.008). They showed that its impact on OS was only observed in Caucasian patients (HR: 1.45, p = 0.005), but not in African Americans, suggesting a difference between ethnic groups.…”

Section: Vitamin D Level In Multiple Myeloma At Diagnosismentioning

confidence: 99%

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

Ito¹,

Honda²,

Kurokawa

2022

Blood Advances

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Vitamin D deficiency impairs prognosis in many types of cancer; however, its significance in each subtype of hematological malignancies is unclear. In addition, data on the association between pre-transplant vitamin D levels and outcomes of hematopoietic stem cell transplantation (HSCT) are inconsistent. This systematic review and meta-analysis aimed to elucidate the impact of vitamin D levels at diagnosis or pre-HSCT on the prognosis of hematological malignancies. A total of 30 articles and abstracts were extracted from PubMed, Embase, Cochrane Library databases, and conference proceedings. Fixed and random-effect models were used to analyze primary outcomes: overall survival (OS) and progression-free survival (PFS). Lower vitamin D level was significantly associated with poorer OS and PFS in myeloid (hazard ratio [HR]: 1.39, 95% confidence interval [CI] 1.06-1.82; HR: 2.03, 95%CI 1.23-3.32, respectively) and lymphoid malignancies (HR: 2.07, 95%CI 1.79-2.40; HR:1.91, 95%CI 1.61-2.25, respectively), as well as outcomes of several lymphoma subtypes individually. Furthermore, pre-transplant lower vitamin D level was associated with poorer OS in both autologous and allogeneic HSCT (HR: 1.65, 95%CI 1.04-2.61; HR: 1.50, 95%CI 1.03-2.18, respectively). Despite the relatively small number of studies evaluated, these data suggest the importance of vitamin D status in outcomes of hematological malignancies (PROSPERO registration number: CRD42020205821).

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Section: Study Selectionmentioning

confidence: 99%

Section: Vitamin D Level In Multiple Myeloma At Diagnosismentioning

confidence: 99%

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

Ito¹,

Honda²,

Kurokawa

2022

Blood Advances

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“…Therefore, we aimed to test the hypothesis that serum 25(OH)D concentration is associated with mental health and life stress measurements including depression, trait anxiety, perceived stress, and hostility in young adults. Moreover, previous studies have found a race difference in the effects of vitamin D on health outcomes [ 25 , 26 ], and sex hormones are closely related to vitamin D status [ 27 ]. Therefore, we also aimed to investigate gender and race disparities in these associations.…”

Section: Introductionmentioning

confidence: 99%

Serum 25-Hydroxyvitamin D Concentrations Are Associated with Mental Health and Psychosocial Stress in Young Adults

et al. 2020

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We aimed to test the hypothesis that serum 25-hydroxyvitamin D3 (25(OH)D) concentration is associated with mental health and life stress measures in young adults and investigate gender and racial disparities in these associations. This study comprised 327 black and white participants. Depression, trait anxiety, perceived stress, and hostility were measured by the following validated instruments: Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS), and Cook–Medley Hostility Scale (CMHS). Linear regression was used to estimate correlations between serum 25(OH)D concentration and mental health measurements in the total population and in subgroups stratified by gender and race. In this sample (28.2 ± 3.1 years, 52% female, 53% black), serum 25(OH)D concentration was negatively related to BDI, STAI, PSS, total CMHS score, and the majority of CMHS subscale scores (p-values < 0.05). Stratified by gender, most of these associations remained significant only in women (p-values < 0.05). Stratified by race, higher 25(OH)D concentrations in white participants were significantly related to lower BDI, STAI, PSS, and CMHS-cynicism subscales (p-values < 0.05); 25(OH)D concentrations in the black participants were only inversely associated with CMHS and most CMHS subscales (p-values < 0.05) but not with BDI, STAI, and PSS. We present novel findings of consistent inverse relationships between serum 25(OH)D concentration and various measures of mental health and life stress. Long-term interventional studies are warranted in order to investigate the roles of vitamin D supplementation in the prevention and mitigation of depression, anxiety, and psychological stress in young adults.

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“…In a neoplastic subset of patients, most of whom suffered symptomatic multiple myeloma (MM), VitD deficiency was frequently related to a late stage of the disease, reduced survival, and greater risk of the progression and development of pathological fractures in asymptomatic patients [ 26 ]. Pleiomorphisms of the VDR often participate in the development of deficiency states [ 27 ], which can be overcome by supplementation with VitD or analogues. In addition, VitD has been found to improve osteoblastic differentiation and maturation, which also reduces the lineage switching of MM plasma cells through an osteoclast-like transformation.…”

Section: Introductionmentioning

confidence: 99%

Reviewing the Significance of Vitamin D Substitution in Monoclonal Gammopathies

Innao

Allegra

Ginaldi

et al. 2021

IJMS

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Vitamin D is a steroid hormone that is essential for bone mineral metabolism and it has several other effects in the body, including anti-cancer actions. Vitamin D causes a reduction in cell growth by interrupting the cell cycle. Moreover, the active form of vitamin D, i.e., 1,25-dihydroxyvitamin D, exerts various effects via its interaction with the vitamin D receptor on the innate and adaptive immune system, which could be relevant in the onset of tumors. Multiple myeloma is a treatable but incurable malignancy characterized by the growth of clonal plasma cells in protective niches in the bone marrow. In patients affected by multiple myeloma, vitamin D deficiency is commonly correlated with an advanced stage of the disease, greater risk of progression, the development of pathological fractures, and a worse prognosis. Changes in the vitamin D receptor often contribute to the occurrence and progress of deficiencies, which can be overcome by supplementation with vitamin D or analogues. However, in spite of the findings available in the literature, there is no clear standard of care and clinical practice varies. Further research is needed to better understand how vitamin D influences outcomes in patients with monoclonal gammopathies.

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Vitamin D deficiency predicts for poor overall survival in white but not African American patients with multiple myeloma

Abstract: Key Points Vitamin D deficiency is a predictor for poor overall survival in patients with multiple myeloma, even after adjusting for age and stage. This difference is only observed in white patients, not African Americans, even under a lower threshold for deficiency.

Cited by 19 publications

References 14 publications

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

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

Serum 25-Hydroxyvitamin D Concentrations Are Associated with Mental Health and Psychosocial Stress in Young Adults

Reviewing the Significance of Vitamin D Substitution in Monoclonal Gammopathies

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