美国一项新研究发现，机体内维生素D水平与白血病之间存在紧密联系，维生素D不足可能会引起病情恶化，维生素D水平正常则会延长病人存活时间。
这项研究由美国梅奥诊所和艾奥瓦大学的研究人员共同完成，研究涉及390名慢性淋巴细胞白血病患者，其中30％的人在刚患病时被发现维生素D不足（即每毫升血液少于25毫微克）。在以后3年的跟踪调查期间，缺乏维生素D的白血病患者的病情恶化和接受化疗的几率要比其他病人高66％，死亡风险则要高两倍以上。
研究还发现，提高白血病患者的维生素D水平可延长他们的存活时间，这一结论不受与白血病发展有关因素的影响。
研究人员说，他们对另一组白血病患者进行了为期10年的研究，得出了同样结论。
研究人员指出，这一发现将有助于更有效地治疗白血病，因为病人可以根据需要及时补充维生素D，这一方法既简易可行，又不会产生副作用。
研究人员说，他们计划在另一项研究中调理患者的维生素D水平，看是否能以此改善病人的预后。
研究报告刊登在新一期美国学术期刊《血液》杂志上。
推荐英文摘要：
Blood DOI：10.1182/blood-2010-07-295683.
Vitamin D insufficiency and prognosis in chronic lymphocytic leukemia (CLL)
Tait D. Shanafelt1,*, Matthew T. Drake2, Matthew J. Maurer3, Cristine Allmer3, Kari G. Rabe3, Susan L. Slager3, George J. Weiner4, Timothy G. Call1, Brian K. Link4, Clive S. Zent1, Neil E. Kay1, Curtis A. Hanson5, Thomas E. Witzig1 and James R. Cerhan6
1 Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States; 2 Division of Endocrinology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States; 3 Division of Biomedical Statistics " Informatics, Mayo Clinic, Rochester, MN, United States; 4 Division of Hematology, Oncology, and Blood " Marrow Transplantation, Dept. of Internal Medicine, College of Medicine, University of Iowa, Iowa City, IA, United States; 5 Department of Pathology, Mayo Clinic, Rochester, MN, United States; 6 Division of Epidemiology, Mayo Clinic, Rochester, MN, United States
Vitamin D insufficiency is common globally with low levels linked to higher cancer incidence. Although vitamin D insufficiency is related to inferior prognosis in some cancers, no data exist for chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL). We evaluated the relationship of 25(OH)D serum levels with time-to-treatment(TTT) and overall survival(OS) in newly diagnosed CLL patients participating in a prospective cohort study(discovery cohort) and a separate cohort of previously untreated patients participating in an observational study(confirmation cohort). Of 390 CLL patients in the discovery cohort, 119(30.5%) were 25(OH)D insufficient. After median follow-up of 3 years, TTT(hazard ratio[HR]=1.66; p=0.005) and OS(HR=2.39; p=0.01) were shorter for 25(OH)D insufficient patients. In the validation cohort, 61 of 153 patients(39.9%) were 25(OH)D insufficient. After median follow-up of 9.9 years, TTT(HR=1.59; p=0.05) and OS(HR 1.63; p=0.06) were again shorter for 25(OH)D insufficient patients. On pooled multivariable analysis of patients in both cohorts adjusting for age, sex, stage, CD38, ZAP-70, IGHV, CD49d, and FISH, 25(OH)D insufficiency remained an independent predictor of TTT(HR=1.47; p=0.008), although the association with OS was not significant(HR=1.47; p=0.07). Vitamin D insufficiency is associated with inferior TTT and OS in CLL patients. Whether normalizing vitamin D levels in deficient CLL patients would improve outcome merits clinical testing.
