Low serum vitamin D levels are associated with inferior survival in follicular lymphoma

A prospective evaluation in SWOG and LYSA studies

Jennifer L. Kelly, Gilles Salles, Bryan Goldman, Richard I. Fisher, Pauline Brice, Oliver Press, Olivier Casasnovas, David G. Maloney, Pierre Soubeyran, Lisa M Rimsza, Corinne Haioun, Luc Xerri, Michael LeBlanc, Hervé Tilly, Jonathan W. Friedberg

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Purpose: Recent literature reports a potential association between high vitamin D and improved lymphoma prognosis. We evaluated the impact of pretreatment vitamin D on follicular lymphoma (FL) outcome. Patients and Methods: SWOG participants were previously untreated patients with FL enrolled onto SWOG clinical trials (S9800, S9911, or S0016) involving CHOP chemotherapy plus an anti-CD20 antibody (rituximab or iodine-131 tositumomab) between 1998 and 2008. Participants included in our second independent cohort were also previously untreated patients with FL enrolled onto the Lymphoma Study Association (LYSA) PRIMA trial of rituximab plus chemotherapy (randomly assigned to rituximab maintenance v observation) between 2004 and 2007. Using the gold-standard liquid chromatography-tandem mass spectrometry method, 25-hydroxyvitamin D was measured in stored baseline serum samples. The primary end point was progression-free survival (PFS). Results: After a median follow-up of 5.4 years, the adjusted PFS and overall survival hazard ratios for the SWOG cohort were 1.97 (95% CI, 1.10 to 3.53) and 4.16 (95% CI, 1.66 to 10.44), respectively, for those who were vitamin D deficient (< 20 ng/mL; 15% of cohort). After a median follow-up of 6.6 years, the adjusted PFS and overall survival hazard ratios for the LYSA cohort were 1.50 (95% CI, 0.93 to 2.42) and 1.92 (95% CI, 0.72 to 5.13), respectively, for those who were vitamin D deficient (< 10 ng/mL; 25% of cohort). Conclusion: Although statistical significance was not reached in the LYSA cohort, the consistent estimates of association between low vitamin D levels and FL outcomes in two independent cohorts suggests that serum vitamin D might be the first potentially modifiable factor to be associated with FL survival. Further investigation is needed to determine the effects of vitamin D supplementation in this clinical setting.

Original languageEnglish (US)
Pages (from-to)1482-1490
Number of pages9
JournalJournal of Clinical Oncology
Volume33
Issue number13
DOIs
StatePublished - May 1 2015

Fingerprint

Follicular Lymphoma
Vitamin D
Lymphoma
Survival
Serum
Disease-Free Survival
Cohort Studies
Drug Therapy
Tandem Mass Spectrometry
Liquid Chromatography
Gold
Anti-Idiotypic Antibodies
Maintenance
Observation
Clinical Trials
Rituximab

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Low serum vitamin D levels are associated with inferior survival in follicular lymphoma : A prospective evaluation in SWOG and LYSA studies. / Kelly, Jennifer L.; Salles, Gilles; Goldman, Bryan; Fisher, Richard I.; Brice, Pauline; Press, Oliver; Casasnovas, Olivier; Maloney, David G.; Soubeyran, Pierre; Rimsza, Lisa M; Haioun, Corinne; Xerri, Luc; LeBlanc, Michael; Tilly, Hervé; Friedberg, Jonathan W.

In: Journal of Clinical Oncology, Vol. 33, No. 13, 01.05.2015, p. 1482-1490.

Research output: Contribution to journalArticle

Kelly, JL, Salles, G, Goldman, B, Fisher, RI, Brice, P, Press, O, Casasnovas, O, Maloney, DG, Soubeyran, P, Rimsza, LM, Haioun, C, Xerri, L, LeBlanc, M, Tilly, H & Friedberg, JW 2015, 'Low serum vitamin D levels are associated with inferior survival in follicular lymphoma: A prospective evaluation in SWOG and LYSA studies', Journal of Clinical Oncology, vol. 33, no. 13, pp. 1482-1490. https://doi.org/10.1200/JCO.2014.57.5092
Kelly, Jennifer L. ; Salles, Gilles ; Goldman, Bryan ; Fisher, Richard I. ; Brice, Pauline ; Press, Oliver ; Casasnovas, Olivier ; Maloney, David G. ; Soubeyran, Pierre ; Rimsza, Lisa M ; Haioun, Corinne ; Xerri, Luc ; LeBlanc, Michael ; Tilly, Hervé ; Friedberg, Jonathan W. / Low serum vitamin D levels are associated with inferior survival in follicular lymphoma : A prospective evaluation in SWOG and LYSA studies. In: Journal of Clinical Oncology. 2015 ; Vol. 33, No. 13. pp. 1482-1490.
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title = "Low serum vitamin D levels are associated with inferior survival in follicular lymphoma: A prospective evaluation in SWOG and LYSA studies",
abstract = "Purpose: Recent literature reports a potential association between high vitamin D and improved lymphoma prognosis. We evaluated the impact of pretreatment vitamin D on follicular lymphoma (FL) outcome. Patients and Methods: SWOG participants were previously untreated patients with FL enrolled onto SWOG clinical trials (S9800, S9911, or S0016) involving CHOP chemotherapy plus an anti-CD20 antibody (rituximab or iodine-131 tositumomab) between 1998 and 2008. Participants included in our second independent cohort were also previously untreated patients with FL enrolled onto the Lymphoma Study Association (LYSA) PRIMA trial of rituximab plus chemotherapy (randomly assigned to rituximab maintenance v observation) between 2004 and 2007. Using the gold-standard liquid chromatography-tandem mass spectrometry method, 25-hydroxyvitamin D was measured in stored baseline serum samples. The primary end point was progression-free survival (PFS). Results: After a median follow-up of 5.4 years, the adjusted PFS and overall survival hazard ratios for the SWOG cohort were 1.97 (95{\%} CI, 1.10 to 3.53) and 4.16 (95{\%} CI, 1.66 to 10.44), respectively, for those who were vitamin D deficient (< 20 ng/mL; 15{\%} of cohort). After a median follow-up of 6.6 years, the adjusted PFS and overall survival hazard ratios for the LYSA cohort were 1.50 (95{\%} CI, 0.93 to 2.42) and 1.92 (95{\%} CI, 0.72 to 5.13), respectively, for those who were vitamin D deficient (< 10 ng/mL; 25{\%} of cohort). Conclusion: Although statistical significance was not reached in the LYSA cohort, the consistent estimates of association between low vitamin D levels and FL outcomes in two independent cohorts suggests that serum vitamin D might be the first potentially modifiable factor to be associated with FL survival. Further investigation is needed to determine the effects of vitamin D supplementation in this clinical setting.",
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T1 - Low serum vitamin D levels are associated with inferior survival in follicular lymphoma

T2 - A prospective evaluation in SWOG and LYSA studies

AU - Kelly, Jennifer L.

AU - Salles, Gilles

AU - Goldman, Bryan

AU - Fisher, Richard I.

AU - Brice, Pauline

AU - Press, Oliver

AU - Casasnovas, Olivier

AU - Maloney, David G.

AU - Soubeyran, Pierre

AU - Rimsza, Lisa M

AU - Haioun, Corinne

AU - Xerri, Luc

AU - LeBlanc, Michael

AU - Tilly, Hervé

AU - Friedberg, Jonathan W.

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N2 - Purpose: Recent literature reports a potential association between high vitamin D and improved lymphoma prognosis. We evaluated the impact of pretreatment vitamin D on follicular lymphoma (FL) outcome. Patients and Methods: SWOG participants were previously untreated patients with FL enrolled onto SWOG clinical trials (S9800, S9911, or S0016) involving CHOP chemotherapy plus an anti-CD20 antibody (rituximab or iodine-131 tositumomab) between 1998 and 2008. Participants included in our second independent cohort were also previously untreated patients with FL enrolled onto the Lymphoma Study Association (LYSA) PRIMA trial of rituximab plus chemotherapy (randomly assigned to rituximab maintenance v observation) between 2004 and 2007. Using the gold-standard liquid chromatography-tandem mass spectrometry method, 25-hydroxyvitamin D was measured in stored baseline serum samples. The primary end point was progression-free survival (PFS). Results: After a median follow-up of 5.4 years, the adjusted PFS and overall survival hazard ratios for the SWOG cohort were 1.97 (95% CI, 1.10 to 3.53) and 4.16 (95% CI, 1.66 to 10.44), respectively, for those who were vitamin D deficient (< 20 ng/mL; 15% of cohort). After a median follow-up of 6.6 years, the adjusted PFS and overall survival hazard ratios for the LYSA cohort were 1.50 (95% CI, 0.93 to 2.42) and 1.92 (95% CI, 0.72 to 5.13), respectively, for those who were vitamin D deficient (< 10 ng/mL; 25% of cohort). Conclusion: Although statistical significance was not reached in the LYSA cohort, the consistent estimates of association between low vitamin D levels and FL outcomes in two independent cohorts suggests that serum vitamin D might be the first potentially modifiable factor to be associated with FL survival. Further investigation is needed to determine the effects of vitamin D supplementation in this clinical setting.

AB - Purpose: Recent literature reports a potential association between high vitamin D and improved lymphoma prognosis. We evaluated the impact of pretreatment vitamin D on follicular lymphoma (FL) outcome. Patients and Methods: SWOG participants were previously untreated patients with FL enrolled onto SWOG clinical trials (S9800, S9911, or S0016) involving CHOP chemotherapy plus an anti-CD20 antibody (rituximab or iodine-131 tositumomab) between 1998 and 2008. Participants included in our second independent cohort were also previously untreated patients with FL enrolled onto the Lymphoma Study Association (LYSA) PRIMA trial of rituximab plus chemotherapy (randomly assigned to rituximab maintenance v observation) between 2004 and 2007. Using the gold-standard liquid chromatography-tandem mass spectrometry method, 25-hydroxyvitamin D was measured in stored baseline serum samples. The primary end point was progression-free survival (PFS). Results: After a median follow-up of 5.4 years, the adjusted PFS and overall survival hazard ratios for the SWOG cohort were 1.97 (95% CI, 1.10 to 3.53) and 4.16 (95% CI, 1.66 to 10.44), respectively, for those who were vitamin D deficient (< 20 ng/mL; 15% of cohort). After a median follow-up of 6.6 years, the adjusted PFS and overall survival hazard ratios for the LYSA cohort were 1.50 (95% CI, 0.93 to 2.42) and 1.92 (95% CI, 0.72 to 5.13), respectively, for those who were vitamin D deficient (< 10 ng/mL; 25% of cohort). Conclusion: Although statistical significance was not reached in the LYSA cohort, the consistent estimates of association between low vitamin D levels and FL outcomes in two independent cohorts suggests that serum vitamin D might be the first potentially modifiable factor to be associated with FL survival. Further investigation is needed to determine the effects of vitamin D supplementation in this clinical setting.

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