Mayo Clinic researchers found a significant difference in the progression of cancer and even death of patients with chronic lymphocytic leukemia (CLL) which did not have enough blood levels of vitamin D, compared to those who do have. In the study, published online in the journal "Blood", the scientists found that patients with low vitamin D at diagnosis of leukemia progressed much faster and were twice as likely to die than those who had adequate levels vitamin D.
also discovered the following specific trends: the increasing levels of vitamin D were directly related to longer survival, while decreasing levels of vitamin D were associated with shorter intervals between diagnosis and progression of cancer. This relationship held even after controlling for other prognostic factors related to development of leukemia.
The discovery is important in several ways. For the first time, you may be able to offer patients a way to stop the advance of this type of leukemia generally slower growth, says the study's lead author, Dr. Tait Shanafelt, hematologist Mayo Clinic in Rochester, Minnesota.
"This discovery was particularly important in this type of leukemia because, although it is usually identified in the early stages, the standard approach is to wait until symptoms develop before administering chemotherapy to patients," says Dr. Shanafelt . "This approach of watching and waiting is difficult for patients because they feel that there is nothing they can do to help."
"It seems that vitamin D levels may be a modifiable risk factor in the progression of leukemia. It is easier for patients to ask their doctors to check their vitamin D levels through a blood test and, if any deficiency, is widely available vitamin D supplements that involve minimal side effects, "added the doctor.
Although scientists have not determined yet whether vitamin D replacement in patients who start with low reverse faster progress linked to the lack of this vitamin, it is intended to conduct a study to explore this hypothesis.
This research adds to the growing body of evidence with respect to vitamin D deficiency is a risk factor for the development and / or progression of several types of cancer, scientists noted. Some studies have have suggested that low blood levels of vitamin D could be linked to increased incidence of colorectal, breast and other organs. In addition, other studies have suggested that low vitamin D at diagnosis could be related to poorer outcomes for patients with colorectal, breast, lung and melanoma, as well as lymphoma.
Scientists say they have been found to replace vitamin D is helpful in some patients. They cite, for example, a placebo-controlled clinical trial that found that women who increased intake of vitamin D reduced the risk of developing cancer.
In general, vitamin D insufficiency is common, says Dr. Shanafelt. "In 25 to 50 percent of patients attending routine medical care there is a vitamin D level below the optimum range and it is estimated that up to one billion people worldwide suffer from vitamin D deficiency."
get Vitamin D through skin exposure to sunlight, certain foods (oily fish and eggs) and supplements.
In this study, the research team, which also included physicians from the University of Iowa, enrolled 390 patients with chronic lymphocytic leukemia in a prospective study observation. We examined the blood of patients with newly diagnosed to review the 25-hydroxyvitamin D concentration in plasma and found that 30 percent of those with CLL could be considered as people with low vitamin D, classification based on a level below 25 nanograms per milliliter.
After an average follow up of 3 years, it was observed that in patients with CLL and vitamin D had a 66 percent chance that the cancer progressed and required chemotherapy plus twice the risk of death.
To confirm these results, we then studied a different group of 153 patients with CLL, who had not received treatment, but only followed for an average of 10 years. The scientists found that nearly 40 percent of the 153 patients with CLL had vitamin D deficiency at diagnosis. Again it was observed in patients with vitamin D deficiency that the possibility of advancement of leukemia or death was much higher, says Dr. Shanafelt.
"This suggests that vitamin D deficiency could be the first potentially modifiable risk factor in the prognosis of a patient with newly diagnosed chronic lymphocytic leukemia," he concludes.
The study was funded by National Institutes of Health, Gabrielle's Angel Foundation for Cancer Research, the Henry J. Predolin, Vysis Inc., and Hematologic Cancer Fund in May. The authors declare no conflict of interest.
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