Effect of Vitamin D and Skeletal Muscle Mass on Prognosis of Patients with Diffuse Large B-Cell Lymphoma.

in Nutrients by Nobuhiko Nakamura, Nobuhiro Kanemura, Takuro Matsumoto, Hiroshi Nakamura, Yuhei Shibata, Kimihiro Yamaguchi, Junichi Kitagawa, Yoshikazu Ikoma, Tomomi Suzaki, Yuto Kaneda, Soranobu Ninomiya, Eri Takada, Takeshi Hara, Hisashi Tsurumi, Masahito Shimizu

TLDR

  • This study looked at how low levels of vitamin D and reduced muscle mass in people with a type of cancer called diffuse large B-cell lymphoma (DLBCL) affected their chances of surviving. The study used data from 186 people who had been newly diagnosed with DLBCL between 2012 and 2022. The study found that people with low levels of vitamin D and reduced muscle mass had a higher chance of their cancer coming back or causing them to die. The study also found that measuring the levels of vitamin D and muscle mass in people with DLBCL could help doctors identify those at higher risk of recurrence or death. The study suggests that doctors could use this information to develop new treatments for people with DLBCL.

Abstract

This study investigated the prognostic impact of vitamin D deficiency and reduced skeletal muscle mass in diffuse large B-cell lymphoma (DLBCL) patients. A retrospective analysis of 186 newly diagnosed DLBCL patients from 2012 to 2022 was conducted, measuring serum 25-hydroxyvitamin D [25(OH)D] levels and the skeletal muscle index (SMI). Decreased vitamin D levels were linked to more severe DLBCL disease, with a median 25(OH)D concentration of 13 (4.0-27) ng/mL. Males in the group with a low SMI had a considerably lower 25(OH)D concentration. The optimal threshold of 25(OH)D levels for overall survival (OS) was 9.6 ng/mL, with lower values associated with a higher likelihood of recurrence and mortality. Multivariable analysis showed hazard ratios for OS of 1.4 [95% CI 0.77-2.5] for a low SMI and 3.2 [95% CI 1.8-5.8] for low 25(OH)D concentration. The combination of a low SMI and low vitamin D concentration resulted in the worst prognosis. Thus, low levels of vitamin D associated with disease progression significantly impact DLBCL prognosis, which can be further stratified by the SMI, providing valuable insights for patient management and potential therapeutic interventions.

Overview

  • The study investigates the prognostic impact of vitamin D deficiency and reduced skeletal muscle mass in diffuse large B-cell lymphoma (DLBCL) patients. The study uses a retrospective analysis of 186 newly diagnosed DLBCL patients from 2012 to 2022, measuring serum 25-hydroxyvitamin D (25(OH)D) levels and the skeletal muscle index (SMI).
  • The primary objective of the study is to determine the prognostic impact of vitamin D deficiency and reduced skeletal muscle mass in DLBCL patients. The study aims to identify the optimal threshold of 25(OH)D levels for overall survival (OS) and the hazard ratios for OS associated with a low SMI and low 25(OH)D concentration. The study also aims to determine the combination of a low SMI and low vitamin D concentration as the worst prognosis for DLBCL patients.

Comparative Analysis & Findings

  • Decreased vitamin D levels were linked to more severe DLBCL disease, with a median 25(OH)D concentration of 13 (4.0-27) ng/mL. Males in the group with a low SMI had a considerably lower 25(OH)D concentration. The optimal threshold of 25(OH)D levels for overall survival (OS) was 9.6 ng/mL, with lower values associated with a higher likelihood of recurrence and mortality. Multivariable analysis showed hazard ratios for OS of 1.4 [95% CI 0.77-2.5] for a low SMI and 3.2 [95% CI 1.8-5.8] for low 25(OH)D concentration. The combination of a low SMI and low vitamin D concentration resulted in the worst prognosis. The study found that low levels of vitamin D associated with disease progression significantly impact DLBCL prognosis, which can be further stratified by the SMI, providing valuable insights for patient management and potential therapeutic interventions.

Implications and Future Directions

  • The study's findings suggest that low levels of vitamin D associated with disease progression significantly impact DLBCL prognosis. The study highlights the importance of measuring 25(OH)D levels and the SMI in DLBCL patients to identify those at high risk of recurrence and mortality. The study also suggests that therapeutic interventions targeting vitamin D deficiency and reduced skeletal muscle mass may be beneficial for DLBCL patients. Future research should focus on developing targeted therapies for DLBCL patients with low levels of vitamin D and reduced skeletal muscle mass, as well as investigating the potential role of vitamin D in the development and progression of DLBCL.
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