25-Hydroxyvitamin D Concentrations and Overall Survival in Autologous Hematopoietic Stem Cell Transplant Subjects

PURPOSE:Prior studies have suggested associations with vitamin D concentrations, increased survival and prognosis in patients with lymphoma and multiple myeloma (MM); however little is known about patients undergoing autologous hematopoietic stem cell transplant (AHSCT). We, thus, investigated pre-AHSCT 25-hydroxyvitamin D [25(OH)D] concentrations and transplant related parameters to determine incidence of vitamin D insufficiency and overall survival in subjects diagnosed with MM and lymphoma.

METHODS:An IRB approved waiver of consent retrospective analysis was performed at Seattle Cancer Care Alliance (SCCA) in Seattle, Washington. Retrospective data, from May 2009 and May 2010, were collected from the electronic medical records of AHSCT adults (n=132) diagnosed with MM (n=70) and lymphoma (n=62). Variables collected included mean pre-AHSCT total 25(OH)D concentrations, age, gender, race, ethnicity, geographic residence, body mass index (BMI), vitamin D-containing supplement use, date of death, and date of last contact.

RESULTS: The majority of both male and female subjects were >50 years old, white and non-Hispanic/Latino, overweight or obese, living above the 37^th parallel, and reported the use of a vitamin D-containing supplement. Age was positively associated to disease (p = 0.002, t-test), whereas other parameters were not. Mean pre-transplant 25(OH)D concentrations of 29.0 ± 11.0ng/mL (p = <0.001, t-test) suggested a significant incidence of vitamin D insufficiency in the sample. The reported use of a vitamin D-containing supplement was the only parameter significantly associated with 25(OH)D concentrations (p = 0.014). Ultimately, pre-transplant vitamin D status (insufficient vs sufficient) had no significant impact on overall survival in subject’s post-AHSCT [HR = 0.99 (95% CI 0.45-2.20) Log-rank p= 0.997].

CONCLUSION: The majority of lymphoma and MM patients have insufficient pre-AHSCT 25(OH)D concentrations. In contrast to prior studies, no association of 25(OH)D and survival was observed. These findings support a rationale to continue this investigation in a larger prospective sample.