Vitamin D supplements may extend treatment-free period for asymptomatic chronic leukemia
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Key takeaways:
- Patients who took vitamin D supplements had significantly longer a median treatment-free survival.
- Results require confirmation in a prospective study.
Adults with chronic lymphocytic leukemia under active surveillance had a significantly longer treatment-free survival period if they took vitamin D supplements, results from a retrospective study published in Blood Advances showed.
Researchers also reported an association between vitamin D supplementation and longer time to first treatment among patients aged 65 years or less.
“While vitamin D supplementation was found to have a positive effect on [time to first treatment, it was not statistically significant,” Tamar Tadmor, MD, director of the division of hematology and blood bank at Bnai Zion Medical Center in Haifa, Israel, and researchers wrote. “We divided the cohort into two subcohorts: young (age 65) and old (age > 65). We found that vitamin D supplement was statistically significant for longer [time to first treatment] in the young cohort, but not for the older subcohort.”
Background, methods
Results from a limited number of previous studies have suggested that low levels of vitamin D are associated both with shorter time to first treatment and inferior OS among patients with chronic lymphocytic leukemia (CLL).
However, little data exists on the potential effect of vitamin D supplementation and its potential clinical outcomes within this patient population.
Researchers conducted a retrospective study to assess the clinical benefit of vitamin D supplementation, or one of its analogs, on time to first treatment and treatment-free survival among a cohort of adults (n = 3,474) with asymptomatic CLL under a watch-and-wait active surveillance approach.
Of the patients in the study, 931 (26.8%) received vitamin D supplements or its analog for at least 6 months. Of those 931 patients, 845 received vitamin D supplements and 52 received vitamin D analog, while 34 received both.
Study investigators noted a median follow-up for the entire cohort from the beginning of the study until first treatment or death of 1,745 days (range, 603 -3,700).
Results, next steps
After adjusting for immortal time bias, Tadmor and colleagues observed a statistically significant association between patients who received vitamin D supplementation during their active surveillance period and longer treatment-free survival (P = .004). They reported a median treatment-free survival time of 169 months among vitamin D users compared with 84 months for non-users.
Further analysis revealed statistically significant longer time to first treatment among a younger cohort of patients aged less than 66 years (P = .038) but the association did not reach statistical significance for patients above that age.
Study limitations included its retrospective nature, the lack of genetic background of CLL and the unknown possibility that patients could have purchased vitamin D supplements over the counter on their own during the study.
“Our long-term retrospective study demonstrates that the administration of vitamin D to patients with CLL in a watch-and-wait active surveillance is significantly associated with a longer treatment-free survival (in any age) and a longer time to first treatment among young patients,” researchers wrote. “A prospective clinical trial is needed to validate results.”
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