Serum 25-hydroxyvitamin D levels in relation to disease status and prognosis in acute myeloid leukemia

Background Low vitamin D levels are linked to higher incidence of cancer. Although vitamin D insufficiency is related to inferior prognosis in some cancers, no data exist for acute leukemia. Aim of the work To evaluate the relationship between serum 25-hydroxyvitamin D (25[OH]D) levels and disease status in acute myeloid leukemia (AML) and correlate these levels with prognostic markers of the disease. Materials and Methods Sixty AML patients, 32 newly diagnosed, 15 in relapse, and 13 in complete remission, as well as 30 healthy control individuals were studied using enzyme-linked immunosorbent assay for the measurement of serum 25[OH]D. Results There was a significantly lower white blood cell count, hemoglobin level, platelet count, and serum vitamin D level among AML patients compared with the control group. Vitamin D-insufficient patients showed lower hemoglobin levels and platelet counts, together with a higher lactate dehydrogenase level, higher percentage of peripheral blood blasts infiltration, and higher percentage of bone marrow blasts' infiltration compared with vitamin D-sufficient patients. Vitamin D levels showed a significantly higher median value among patients who had favorable cytogenetics and a higher median value among those who showed complete remission than those newly diagnosed or in relapse. Survival curve analysis showed shorter overall survival of vitamin D-insufficient patients compared with vitamin D-sufficient patients. Conclusion and Recommendations Vitamin D level is related to the active stage of the disease and therefore aggressiveness of the disease. It can be used as a prognostic tool for survival in AML patients. It is recommended that further evaluation be carried out on a large number of patients with a longer follow-up period and that it is incorporated into the routine evaluation of all AML patients. Additional studies are needed to determine the exact role of vitamin D in acute leukemia and whether it could be used as a therapeutic or a preventive approach. (C) 2014 The Egyptian Society of Haematology.