Department of Internal Medicine, Discipline of Hematology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Department of Internal Medicine, Discipline of Clinical Practical Skills, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Curr Oncol. 2023 Apr 20;30(4):4351-4364. doi: 10.3390/curroncol30040331.
Vitamin D deficiency has been correlated with various conditions, including the risk of developing lymphoid malignancies. This systematic review aimed to assess the association between vitamin D levels at diagnosis of lymphoid malignancies, patient outcomes, and survival. A systematic review was conducted, encompassing 15 studies published until January 2023, involving 4503 patients, examining the relationship between vitamin D and lymphoid cancers. The median age of the patients was 56.5 years, with a median follow-up duration of approximately 36 months across studies. The overall median vitamin D level at initial measurement was 20.4 ng/mL, while a <20 ng/mL threshold was used to define vitamin D insufficiency. The results demonstrated significant associations between vitamin D levels and patient outcomes in several lymphoid malignancies, with a pooled risk in disease progression of 1.93 and a pooled hazard ratio of 2.06 for overall survival in patients with 25-(OH)D levels below the normal threshold of 20 ng/mL. Among findings, it was demonstrated that supplemental vitamin D improves the chemosensitivity of tumors by reducing the rate of tumor growth compared with vitamin D or chemotherapy alone. Vitamin D had a protective effect for patients with DLBCL under R-CHOP treatment, while vitamin D insufficiency was associated with the impairment of rituximab treatment and showed worse clinical outcomes in chimeric antigen receptor T-cell (CAR-T) recipients. Although one study found no association between vitamin D deficiency and the cause of death, most associated vitamin D insufficiency with early clinical failure and lower survival probability. In conclusion, his systematic review highlights the importance of vitamin D levels in the prognosis and survival of patients with lymphoid malignancies. Further research is needed to better understand the underlying mechanisms and explore the potential benefits of vitamin D supplementation in managing these cancers.
维生素 D 缺乏与多种疾病相关,包括发生淋巴恶性肿瘤的风险。本系统综述旨在评估诊断为淋巴恶性肿瘤时的维生素 D 水平与患者结局和生存之间的关系。我们进行了系统综述,纳入截至 2023 年 1 月发表的 15 项研究,共涉及 4503 例患者,以研究维生素 D 与淋巴癌之间的关系。患者的中位年龄为 56.5 岁,各项研究的中位随访时间约为 36 个月。初始测量时的总体中位维生素 D 水平为 20.4ng/ml,而将<20ng/ml 作为维生素 D 不足的阈值。结果表明,维生素 D 水平与几种淋巴恶性肿瘤患者的结局之间存在显著关联,25-(OH)D 水平低于正常阈值 20ng/ml 的患者疾病进展的汇总风险比为 1.93,总生存的汇总风险比为 2.06。研究结果还表明,与单独使用维生素 D 或化疗相比,补充维生素 D 通过降低肿瘤生长速度来提高肿瘤的化疗敏感性。在接受 R-CHOP 治疗的 DLBCL 患者中,维生素 D 具有保护作用,而维生素 D 不足与利妥昔单抗治疗效果受损有关,并且在嵌合抗原受体 T 细胞(CAR-T)接受者中显示出更差的临床结局。尽管一项研究未发现维生素 D 缺乏与死亡原因之间存在关联,但大多数研究将维生素 D 不足与早期临床失败和较低的生存概率相关联。综上所述,本系统综述强调了维生素 D 水平在淋巴恶性肿瘤患者的预后和生存中的重要性。需要进一步研究以更好地了解潜在机制,并探讨维生素 D 补充在管理这些癌症方面的潜在益处。