Vitamin D Deficiency Adversely Impacts Multiple Myeloma

Last Updated: 2009-07-21 11:14:07 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Vitamin D deficiency may predict a poorer outcome in patients with newly diagnosed multiple myeloma, researchers from the Mayo Clinic in Rochester, Minnesota, report in the July issue of the American Journal of Hematology.

Among 148 patients with newly diagnosed multiple myeloma who had serum 25-hydroxyvitamin D levels obtained within 14 days of diagnosis, Dr. Matthew T. Drake and colleagues found that 24% had vitamin D deficiency, with levels of 25-hydroxyvitamin D less than 50 nmol/L (20 ng/mL).

Compared to subjects without vitamin D deficiency, those with vitamin D deficiency had higher mean values of serum C-reactive protein (2.40 mg/L vs 0.84 mg/L, p = 0.02) and creatinine (1.75 mg/dL versus 1.24 mg/dL, p = 0.03), respectively.

"Both CRP and creatinine levels have been shown to predict prognosis in multiple myeloma, with higher levels of both CRP and creatinine shown to portend poorer outcomes and survival," Dr. Drake and colleagues point out.

According to the investigators, the proportion of patients with vitamin D deficiency increased as the stage of multiple myeloma worsened. Vitamin D deficiency was found in 16% of subjects if International Staging System (ISS) was stage I, 20% of subjects in ISS stage II, and 37% in ISS stage III.

Contrary to the researchers" hypothesis, there were no differences in skeletal morbidity between subjects with and without vitamin D deficiency at the time of diagnosis.

This finding, however, "does not preclude the possibility that vitamin D deficiency may have an important role in the subsequent development of new skeletal events or in progression of multiple myeloma bone disease following diagnosis," the investigators note.

"Our study," they conclude, "provides intriguing data on the relationship between vitamin D and prognosis in multiple myeloma and suggests a need for larger population-based studies both to confirm our findings and to prospectively assess the role of vitamin D deficiency in disease progression, overall survival, and quality of life in subjects with newly diagnosed multiple myeloma."

Source:

Am J Hematol 2009;84:397-400.


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