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Meta-Analysis
. 2022 Mar 8;6(5):1499-1511.
doi: 10.1182/bloodadvances.2021004958.

Impact of vitamin D level at diagnosis and transplantation on the prognosis of hematological malignancy: a meta-analysis

Yusuke Ito  1 , Akira Honda  1 , Mineo Kurokawa  1   2
Affiliations
Meta-Analysis

Impact of vitamin D level at diagnosis and transplantation on the prognosis of hematological malignancy: a meta-analysis

Yusuke Ito et al. Blood Adv. .

Abstract

Vitamin D deficiency impairs prognosis in many types of cancer; however, its significance in each subtype of hematological malignancies is unclear. In addition, data on the association between pretransplant vitamin D levels and outcomes of hematopoietic stem cell transplantation (HSCT) are inconsistent. This systematic review and meta-analysis aimed to elucidate the impact of vitamin D levels at diagnosis or pre-HSCT on the prognosis of hematological malignancies. Thirty articles and abstracts were extracted from PubMed, Embase, and Cochrane Library databases and conference proceedings. Fixed and random effect models were used to analyze primary outcomes: overall survival (OS) and progression-free survival (PFS). Lower vitamin D level was significantly associated with poorer OS and PFS in myeloid malignancies (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.06-1.82 and HR, 2.03; 95% CI, 1.23-3.32, respectively) and lymphoid malignancies (HR, 2.07; 95% CI, 1.79-2.40 and HR, 1.91; 95% CI, 1.61-2.25, respectively), as well as outcomes for several lymphoma subtypes individually. Furthermore, a lower pretransplant vitamin D level was associated with poorer OS in autologous and allogeneic HSCT (HR, 1.65; 95% CI, 1.04-2.61 and HR, 1.50; 95% CI, 1.03-2.18, respectively). Despite the relatively small number of studies evaluated, these data suggest the importance of vitamin D status in outcomes of hematological malignancies (PROSPERO registration number: CRD42020205821).

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Figures

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Graphical abstract
Figure 1.
Figure 1.
Preferred Reporting Items For Systematic Reviews And Meta-Analysis (PRISMA) flow diagram of study selection. After screening the titles and abstracts of 1212 articles, 52 articles were considered relevant. Among them, 22 articles were excluded for various reasons; 30 articles were included in the analysis. ASCO, American Society of Clinical Oncology; ASH, American Society of Hematology, EHA, European Hematology Society.
Figure 2.
Figure 2.
Outcomes in myeloid malignancies. HR of OS survival in myeloid malignancies (A) and funnel plot (B). (C) HR of progression-free survival in myeloid malignancies. CML, chronic myeloid leukemia; JMML, juvenile myelomonocytic leukemia; MDS, myelodysplastic syndrome; PMF, primary myelofibrosis; seTE, standard error of treatment estimate; TE, estimated treatment effect.
Figure 3.
Figure 3.
Outcomes in lymphoid malignancies. HR of OS in lymphoid malignancies (A) and funnel plot (B). HR of progression-free survival in lymphoid malignancies (C) and funnel plot (D). ALL, acute lymphoblastic leukemia; BCL, B-cell lymphoma; DLBCL, diffuse large B-cell lymphoma; ENKTL, extranodal natural killer/T-cell lymphoma; FL, follicular lymphoma; HL, Hodgkin lymphoma; MCL, mantle cell lymphoma; NHL, non-Hodgkin lymphoma; R, rituximab; seTE, standard error of treatment estimate; TCL, T-cell lymphoma; TE, estimated treatment effect.
Figure 4.
Figure 4.
Outcomes in DLBCL. HR of OS in DLBCL (A) and funnel plot (B). HR of progression-free survival in DLBCL (C) and funnel plot (D). R, rituximab; seTE, standard error of treatment estimate; TE, estimated treatment effect.
Figure 5.
Figure 5.
Outcomes in each subtype of lymphoid malignancies. HRs of OS (A) and PFS (B) in FL. HRs of OS (C) and PFS (D) in MCL. (E) HR of PFS in HL. HRs of OS (F) and PFS (G) in TCL. HRs of OS (H) and TTT (I) in CLL. seTE, standard error of treatment estimate; TE, estimated treatment effect.
Figure 6.
Figure 6.
Outcomes in HSCT. (A) HR of OS in ASCT. HRs of OS (B), relapse rate (C), and NRM (D) in allo-HSCT. seTE, standard error of treatment estimate; TE, estimated treatment effect.
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References

    1. Christakos S, Dhawan P, Verstuyf A, Verlinden L, Carmeliet G. Vitamin D metabolism, molecular mechanism of action, and pleiotropic effects. Physiol Rev. 2016;96(1):365-408. - PMC - PubMed
    1. Bandera Merchan B, Morcillo S, Martin-Nuñez G, Tinahones FJ, Macías-González M. The role of vitamin D and VDR in carcinogenesis: through epidemiology and basic sciences. J Steroid Biochem Mol Biol. 2017;167:203-218. - PubMed
    1. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266-281. - PubMed
    1. Hall AC, Juckett MB. The role of vitamin D in hematologic disease and stem cell transplantation. Nutrients. 2013;5(6):2206-2221. - PMC - PubMed
    1. Li M, Chen P, Li J, Chu R, Xie D, Wang H. Review: the impacts of circulating 25-hydroxyvitamin D levels on cancer patient outcomes: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2014;99(7):2327-2336. - PubMed