Vitamin D Deficiency in Chronic Lymphocytic Leukaemia: Makurdi Perspective
Keywords:
Chronic lymphocytic leukaemia (CLL), Vitamin DAbstract
Vitamin D is a group of fat-soluble vitamins, commonly known for its critical role in calcium homeostasis and bone mineralization, but more recently it has been implicated in the pathogenesis of hematological cancers and shows promise as an anti-cancer therapy. Serum Vitamin D level has a positive relation with rate of disease progression in Chronic Lymphocytic Leukemia (CLL) and as such Vitamin D deficiency is a poor prognostic factor. This study is designed to evaluate the serum vitamin D concentration in CLL participants in comparison to age-matched non CLL participants. This was a cross-sectional study carried out among CLL patients seeking care in Benue state University Teaching Hospital. Thirty-six CLL patients and 36 healthy age and sex matched controls were recruited for the study.Their Full Blood Count and serum vitamin D levels were determined. Data obtained from the study were analysed using Statistical Package for Social Sciences (SPSS) version 23.0. The concentration of serum vitamin D in the CLL group was significantly lower than that of control. Prevalence of vitamin D deficiency was commoner in the CLL group(52.8%, n=19) compared to controls (5.6%, n=2), P <0.05. There was no correlation between serum Vitamin D and age,Rai stage, neutrophil count, lymphocyte count and haematocrit. However, a negative correlation was found between serum vitamin D and platelet count.There is a high prevalence of Vitamin D deficiency among CLL patients in Makurdi, Benue state. Though this deficiency does not correlate with the Rai stage of the disease. Therefore, serum vitamin D assay should be part of routine investigation done at diagnosis of CLL so that its deficiency can be corrected early.
References
1 Kulling PM, Olson KC, Olson TL, Feith DJ, Loughran TP Jr. Vitamin D in hematological disorders and malignancies. Eur J Haematol. 2017;98(3):187-197. doi:10.1111/ejh.12818
2 Amadi C, Orluwene C, Amadi B. Serum Vitamin D Level Status by Prostate Cancer Grade and Stage Among Native Africans. Am J Lab Med. 2022;7(1):6-15. doi:10.11648/j.ajlm.20220701.12
3 Kipps T. Chronic Lymphocytic Leukemia and Related Diseases. In Kaushansky K, Lichtman M, Kipps T, Seligsohn U, Prchal J(editors). Williams Hematology. 8th ed. New York: McGraw-Hill Companies; 2010.p 1431-1481
4 Onoja AM, Otene SA, Onoja AT, Ibrahim IN, Mke A, Okolie I, et al., Prevalence and Nature of Adult Hematological Malignancies Using Bone Marrow Aspiration Cytology in a Tertiary Health Facility: A Seven Year Retrospective Review. West J Med & Biomed. 2021, April; 2(1): 39-45.
5 Nwannadi IA, Alao OO, Bazuaye GN, Halim NK and Omoti CE. The Epidemiology of Haematological Malignancies at the University of Benin Teaching Hospital: A Ten-Year Retrospective Study. Int. J of Epid. 2010; 9:2; 34-45, doi: 10.5580/1fbb
6 Scarfò L, Ferreri AJ, Ghia P. Chronic lymphocytic leukaemia. Crit Rev Oncol Hematol. 2016;104:169-182. doi:10.1016/j.critrevonc.2016.06.003.
7 Hoffbrand VA. Megaloblastic anaemia. In Hoffbrand VA, Higgs DR, Keeling DM, Mehta AB (editors). Postgraduate Haematology. 7th ed. UK, JohnWiley & Sons Ltd 2015: 53-71.
8 Holtzer-Goor KM, Schaafsma MR, Joosten P, Posthuma EF, Wittebol S, Huijgens PC, et al. Quality of life of patients with chronic lymphocytic leukaemia in the Netherlands: results of a longitudinal multicentre study. Qual Life Res. 2015 Dec;24(12):2895-906. doi: 10.1007/s11136-015-1039-y. Epub 2015 Jul 24. PMID: 26205768; PMCID: PMC4615661.
9 Gerousi M, Psomopoulos F, Kotta K, Tsagiopoulou M, Stavroyianni N, Anagnostopoulos A, et al. The Calcitriol/Vitamin D Receptor System Regulates Key Immune Signaling Pathways in Chronic Lymphocytic Leukemia. Cancers (Basel). 2021 Jan 14;13(2):285. doi: 10.3390/cancers13020285. PMID: 33466695; PMCID: PMC7828837.
10 Kelly JL, Friedberg JW, Calvi LM, van Wijngaarden E, Fisher SG. Vitamin D and non-Hodgkin lymphoma risk in adults: a review. Cancer Invest. 2009;27(9):942-951. doi:10.3109/07357900902849632.
11 Máčová L, Bičíková M. Vitamin D: Current Challenges between the Laboratory and Clinical Practice. Nutrients. 2021;13(6):1758. Published 2021 May 21. doi:10.3390/nu13061758.
12 Holick MF. Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol. 2009;19(2):73-78. doi:10.1016/j.annepidem.2007.12.001.
13 Imazu M. General description of the automated haematology analyser. Sysmex Journal International [Internet]. 2002 [cited 2021 July 18];12(1):12-17. Available from https://www.sysmex.co.jp/en/products-solutions/library/journal/vol12-no1/sum-vol12-1-0-3.pdf.
14 Tadmor T, Melamed G, Alapi H, Gazit S, Patalon T, Rokach L. Vitamin D supplement for patients with early-stage chronic lymphocytic leukemia is associated with a longer time to first treatment. Blood Adv. 2024;8(14):3840-3846. doi:10.1182/bloodadvances.2023011458
15 Kubeczko M, Nowara E, Spychałowicz W, Wdowiak K, Bednarek A, Karwasiecka D, et al. Efficacy and safety of vitamin D supplementation in patients with chronic lymphocytic leukemia. Postepy Hig Med Dosw (Online). 2016 May 21;70(0):534-41. doi: 10.5604/17322693.1202482. PMID: 27333923.
16 Gerousi M, Psomopoulos F, Kotta K, Tsagiopoulou M, Stavroyianni N, Anagnostopoulos A, et al. The Calcitriol/Vitamin D Receptor System Regulates Key Immune Signaling Pathways in Chronic Lymphocytic Leukemia. Cancers (Basel). 2021 Jan 14;13(2):285. doi: 10.3390/cancers13020285. PMID: 33466695; PMCID: PMC7828837.
17 Kılıçaslan E, Kaptan MK . Vitamin D Level in Patients with Chronic Lymphocytic Leukemia and Relationship Between Rai Stage. Hamidiye Med J. 2023 Apr;4(1):35-39. doi:10.4274/hamidiyemedj.galenos.2022.63825.
18 Omoti CE, Awodu OA, Bazuaye GN. Chronic lymphoid leukaemia: clinico-haematological correlation and outcome in a single institution in Niger Delta region of Nigeria. Int J Lab Hematol. 2007;29(6):426-432. doi:10.1111/j.1751-553X.2007.00888x.
19 Dehghani M, Khajeh A, Vojdani R, Sanei M, Keshavarz P, Namdari N.. Serum Vitamin D3 Levels in Chronic Lymphocytic Leukemia and Its Relevance with Clinical Prognostic Factors. Shiraz E-Med J. 2021;22(7):e104751. doi.org/10.5812/semj.104751.
20 O'Connor MY, Thoreson CK, Ramsey NL, Ricks M, Sumner AE. The uncertain significance of low vitamin D levels in African descent populations: a review of the bone and cardiometabolic literature. Prog Cardiovasc Dis. 2013;56(3):261-269. doi:10.1016/j.pcad.2013.10.015.
21 Talebzadeh A, Ghaffari H, Ghaffari K, Yazdanpanah S, Yousefi Goltappeh B, Eslami M, et al. The effect of vitamin D deficiency on platelet parameters in patients with COVID-19. Front Cell Infect Microbiol. 2024 Mar 8;14:1360075. doi: 10.3389/fcimb.2024.1360075. PMID: 38524183; PMCID: PMC10957640.
22 Park YC, Kim J, Seo MS, Hong SW, Cho ES, Kim JK. Inverse relationship between vitamin D levels and platelet indices in Korean adults. Hematology. 2017;22(10):623-629. doi:10.1080/10245332.2017.1318334.
