A prospective single center study from a developing country to evaluate the prevalence of vitamin-D deficiency in patients with de novo hematologic malignancies.

Abstract

e18004 Background: Vitamin-D deficiency is a global problem due to lack of sunlight exposure or dietary deficiency. Few studies have correlated vitamin-D deficiency with poor outcome in patients with diffuse large B-cell lymphomas and chronic lymphocytic leukemia. Expression of vitamin-D receptors on both normal and malignant hematopoietic cells suggests its possible role in pathogenesis, response to therapy and as a potential therapeutic target in haematological cancers. Given the high prevalence of malnutrition in our country and the potential impact of vitamin-D deficiency in haematological malignancies we conducted this prospective study to identify its prevalence in this subset of patients. Methods: Consecutive patients (15-50 years) with de novo haematological cancers who were registered at our centre over a three months period were evaluated. Patients who had received bisphosphonates or calcium and vitamin-D supplementation were excluded. Demographic variables, performance status, lifestyle (sedentary or non-sedentary), diet (vegetarian or mixed), consumption of milk products, serum 25 (OH) D, albumin and calcium levels were recorded. Levels <30ng/ml and <20ng/ml were considered as insufficient and deficient respectively. Results: A total of 126 patients (70% males) were enrolled. Median age was 35 years. Distribution as per histology was acute leukemia-59, lymphomas-53, chronic myeloid leukemia-14. 78% patients had non-sedentary life style and were consuming mixed diet and milk. 90% patients had performance status ≤2. Serum albumin>3.5 gm/dL and normal calcium levels were seen in 90%. Vitamin-D deficiency was seen in 12% patients whereas 73% patients were vitamin D insufficient. Keeping the cut-off <25 ng/mL, 82% patients were deficient. Deficiency did not correlate with age, underlying diagnosis, lifestyle or dietary habits. Conclusions: Our study identified a very high prevalence of vitamin-D deficiency in patients with haematological malignancies. This could be one of the factors responsible for the aggressive nature of disease and poor outcome in our patients.