title: Low 25(OH) vitamin D3 levels are associated with adverse outcome in newly diagnosed, intensively treated adult acute myeloid leukemia.
abstract: BACKGROUND
  Several studies have suggested that low 25(OH) vitamin D3 levels may be prognostic in some malignancies, but no studies have evaluated their impact on treatment outcome in patients with acute myeloid leukemia (AML).
  
  
  METHODS
  Vitamin D levels were evaluated in 97 consecutive, newly diagnosed, intensively treated patients with AML. MicroRNA expression profiles and single nucleotide polymorphisms (SNPs) in the 25(OH) vitamin D3 pathway genes were evaluated and correlated with 25(OH) vitamin D3 levels and treatment outcome.
  
  
  RESULTS
  Thirty-four patients (35%) had normal 25(OH) vitamin D3 levels (32-100 ng/mL), 34 patients (35%) had insufficient levels (20-31.9 ng/mL), and 29 patients (30%) had deficient levels (<20 ng/mL). Insufficient/deficient 25(OH) vitamin D3 levels were associated with worse relapse-free survival (RFS) compared with normal vitamin D3 levels. In multivariate analyses, deficient 25(OH) vitamin D3 , smoking, European Leukemia Network genetic group, and white blood cell count retained their statistical significance for RFS. Several microRNAs and SNPs were associated with 25(OH) vitamin D3 levels, although none remained significant after multiple test corrections; one 25(OH) vitamin D3 receptor SNP, rs10783219, was associated with a lower complete remission rate (P = .0442) and with shorter RFS (P = .0058) and overall survival (P = .0011).
  
  
  CONCLUSIONS
  It remains to be determined what role microRNA and SNP profiles play in contributing to low 25(OH) vitamin D3 level and/or outcome and whether supplementation will improve outcomes for patients with AML.
authors.affiliation: Leukemia Section, Department of Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, New York.
authors.forename: Hun Ju
authors.initials: HJ
authors.lastname: Lee
authors.forename: Josephia R
authors.initials: JR
authors.lastname: Muindi
authors.forename: Wei
authors.initials: W
authors.lastname: Tan
authors.forename: Qiang
authors.initials: Q
authors.lastname: Hu
authors.forename: Dan
authors.initials: D
authors.lastname: Wang
authors.forename: Song
authors.initials: S
authors.lastname: Liu
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Wilding
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Ford
authors.forename: Sheila N J
authors.initials: SN
authors.lastname: Sait
authors.forename: Annemarie W
authors.initials: AW
authors.lastname: Block
authors.forename: Araba A
authors.initials: AA
authors.lastname: Adjei
authors.forename: Maurice
authors.initials: M
authors.lastname: Barcos
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Griffiths
authors.forename: James E
authors.initials: JE
authors.lastname: Thompson
authors.forename: Eunice S
authors.initials: ES
authors.lastname: Wang
authors.forename: Candace S
authors.initials: CS
authors.lastname: Johnson
authors.forename: Donald L
authors.initials: DL
authors.lastname: Trump
authors.forename: Meir
authors.initials: M
authors.lastname: Wetzler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002112:Calcifediol / Q000097:blood*; D002762:Cholecalciferol / Q000097:blood*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000097:blood* / Q000235:genetics / Q000473:pathology; D008297:Male; D035683:MicroRNAs / Q000235:genetics*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000473:pathology; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D011379:Prognosis; D018167:Receptors, Calcitriol / Q000235:genetics; D059467:Transcriptome; D016896:Treatment Outcome
chemical_list: D035683:MicroRNAs; D018167:Receptors, Calcitriol; D002762:Cholecalciferol; D002112:Calcifediol
keywords: acute myeloid leukemia; microRNA; outcome; single nucleotide polymorphism; vitamin D