文章：

维生素D不足与滤泡性淋巴瘤早期临床失败风险增加相关

Vitamin D insufficiency is associated with an increased risk of early clinical failure in follicular lymphoma

原文发布日期：2017-08-25

DOI: 10.1038/bcj.2017.70

类型: Original Article

开放获取: 是

英文摘要：

We evaluated whether vitamin D insufficiency (VDI; 25(OH)D <20 ng/ml) was associated with adverse outcomes among follicular lymphoma (FL) patients using an observational prospective cohort study of 642 FL patients enrolled from 2002–2012. The median age at diagnosis was 60 years. At a median follow-up of 59 months, 297 patients (46%) had an event (progression, treatment failure), 78 had died and 42 (6.5%) had a lymphoma-related death. VDI was associated with inferior event-free survival (EFS) at 12 months (EFS12, odds ratio (OR)=2.05; 95% confidence interval (CI) 1.18–3.54), overall survival (OS, hazards ratio (HR)=2.35; 95%CI 1.37–4.02), and lymphoma-specific survival (LSS, HR=2.97; 95% CI 1.52–5.80) for the full cohort. Among patients treated with immunochemotherapy (IC), VDI was associated with inferior EFS12 (OR=3.00; 95% CI 1.26–7.13), OS (HR=2.86; 95% CI 1.39–5.85), and LSS (HR=2.96; 95% CI 1.29–6.79). For observed patients, VDI was associated with inferior OS (HR=2.85; 95% CI 1.20–6.76). For other therapies, VDI was associated with inferior OS (HR=3.06; 95% CI 1.01–9.24). Our work is the first to reveal an association of VDI with early clinical failure, and to demonstrate an association of VDI with adverse outcomes among patients who are observed or treated with therapies other than IC. Our findings suggest a potentially modifiable prognostic factor to address in patients with FL.

摘要翻译： 

我们通过一项2002-2012年间纳入642例滤泡性淋巴瘤（FL）患者的前瞻性观察队列研究，评估了维生素D不足（VDI；定义为25(OH)D＜20 ng/ml）是否与不良预后相关。诊断时的中位年龄为60岁。在中位59个月的随访期间，297例患者（46%）发生事件（疾病进展、治疗失败），78例死亡，其中42例（6.5%）为淋巴瘤相关死亡。在整个队列中，VDI与12个月无事件生存率降低（EFS12，比值比[OR]=2.05；95%置信区间[CI] 1.18-3.54）、总生存期缩短（OS，风险比[HR]=2.35；95%CI 1.37-4.02）及淋巴瘤特异性生存率下降（LSS，HR=2.97；95%CI 1.52-5.80）显著相关。在接受免疫化疗（IC）的患者中，VDI与较差的EFS12（OR=3.00；95%CI 1.26-7.13）、OS（HR=2.86；95%CI 1.39-5.85）和LSS（HR=2.96；95%CI 1.29-6.79）相关。在观察等待的患者中，VDI与较差的OS相关（HR=2.85；95%CI 1.20-6.76）。在其他治疗方案组中，VDI同样与OS降低相关（HR=3.06；95%CI 1.01-9.24）。本研究首次揭示VDI与早期临床治疗失败存在关联，并证实了在观察等待或接受非IC治疗方案的患者中，VDI与不良预后相关。我们的研究结果提示，维生素D不足可能是滤泡性淋巴瘤患者中一个可干预的潜在预后因素。

原文链接：

Vitamin D insufficiency is associated with an increased risk of early clinical failure in follicular lymphoma