Sunday, November 27, 2016

ASH: Vitamin D and Follicular Lymphoma

Another interesting ASH presentation -- this one is called "Vitamin D Insufficiency Is Associated with an Increased Risk of Early Clinical Failure in Follicular Lymphoma."

I'm very interested in Vitamin D and FL, mostly because I take some every day, on the advice of my doctor. It's kind of a controversial supplement, in that some doctors get very excited about patients taking it, and others are more skeptical, and there are lots of studies that suggest it's a problem not to have enough, and others that aren't quite so sure.

For me, despite my mom's Italian heritage, I'm mostly of fair-skinned Scottish-Canadian ancestry, so I try to stay out of the sun. And that means my body isn't making Vitamin D naturally, so I take a supplement.

Before I go any further, let me be clear: I'm not suggesting that anyone else should take Vitamin D. That's my choice, based on my doctor's advice. You should talk to your own doctor about whether it's a good idea for you.

Also, I'm NOT suggesting that there is any research that says Vitamin D will cure your Follicular Lymphoma. It's easy to get excited about these kinds of potentially easy solutions, but nothing is easy with Follicular Lymphoma, as we all know.

So, on to the study:

Researchers looked at 642 newly-diagnosed FL patients. They wanted to figure out if low Vitamin D levels in the blood could predict if a patient would have early clinical failure (measured by Event-Free Survival at 12 months, or EFS12) and Overall Survival, as well Lymphoma-Specific Survival (death caused by Lymphoma and not something else). They were interested to see if low Vitamin D levels were related to how successful specific treatments were, too.

They found that in the entire group, low Vitamin D levels were associated with inferior EFS12, OS, and LSS -- all three.

The same was true of patients who had Immunochemotherapy (something like R-CHOP or R-B) -- inferior for EFS12, OS, and LSS.

For patients who were observed (watch and wait), low Vitamin D was associated with low Overall Survival, but there was not enough of a connection to say it was associated with EFS12 or LSS.

There were not enough events or deaths to measure any connections for patients who had straight Rituxan. (That's bad for the study, but good overall.)

Their conclusion: "We confirm previous findings that vitamin D insufficiency is associated with adverse long-term prognosis among patients with FL treated with IC, and extend these findings to patients who are initially observed or treated with other therapies.  For the first time, we observed an association of vitamin D insufficiency with early clinical failure, suggesting a potentially modifiable factor to address in this subset of patients with poor outcomes.  Whether treating VDI improves outcomes in FL warrants assessment."

In other words, having low Vitamin D levels can make things worse for you. But that doesn't mean having sufficient or high levels will make things better.

So, it's an interesting study with no firm conclusions, other than to talk to your doctor about whether your Vitamin D levels are OK, and whether or not it matters.


1 comment:

Jurup said...

Thank you for another interesting blog post. I recently came across this article (admittedly for DLBCL) which associates season of diagnosis with OS - which could be related to vitamin D:'s_lymphoma_-_A_population-based_Swedish_Lymphoma_Register_study