A RETROSPECTIVE STUDY OF THE ASSOCIATION OF LOW 25(OH) VITAMIN D3 LEVELS WITH POOR OUTCOMES IN ELDERLY PATIENTS WITH DE NOVO ACUTE MYELOID LEUKAEMIA

Beili Hu^{1, *}, Lihua Chen1, Xiaoyan Wu², Jiangping Wan², Yanxia Han¹, Ju Huang¹, Zhouzheng Wang¹

¹Department of Hematology, the Second Affiliated Hospital of Jiaxing University, Zhejiang, Jiaxing, 314000, People's Republic of China - ²Department of Laboratory, the Second Affiliated Hospital of Jiaxing University, Zhejiang, Jiaxing, 314000, People's Republic of China

A total of 68 patients (age ≥60 years) with de novo AML but not acute promyelocytic leukaemia (M3), 176 patients with osteoporosis and 136 healthy people were enrolled in a study to explore the relationship between serum 25-hydroxyvitamin D3 [25(OH)D3] levels and outcomes in elderly patients with acute myeloid leukaemia (AML). The patients had accepted at least one cycle of induction chemotherapy. Therapy effect, survival time and 25(OH)D3 levels were recorded. For 68 AML patients, age, sex, weight, height and AML type were recorded. Laboratory parameters, including serum electrolytes (phosphorus and Ca²⁺), bone marrow blast cell and complete peripheral blood cell counts, were detected and recorded. The 25(OH)D3 level was 13.03±7.24 in the AML group, which was lower than that in the other groups (16.89±9.39 in the osteoporosis group, P<0.05 and 17.92±9.18 in the healthy group, P<0.05). The 68 AML patients were divided into two groups according to their 25(OH)D3 levels. The high 25(OH)D3 group was younger (69.00±7.50 vs 73.00±8.26, P = 0.045) and had a lower blast cell count (52.99±22.07 vs 64.58±23.07, P = 0.044), lower risk karyotype (P = 0.001), higher serum albumin levels (38.03±5.61 vs 34.00±7.44, P = 0.014), and longer event-free survival(EFS) and overall survival (OS) than the low 25(OH)D3 group (P<0.0001). In multivariate analyses, 25(OH)D3 levels (HR 0.95, 95%CI 0.907–0.996, P = 0.034), cytogenetic risk classification (HR 5.077, 95%CI 2.567–10.042, P<0.00), and age (HR 1.038, 95%CI 1.005–1.071, P = 0.022) were independent prognostic factors. Serum 25(OH)D3 levels were significantly lower in elderly AML patients than in elderly osteoporosis patients and healthy elderly individuals. Low 25(OH)D3 levels might be an indicator of poor prognosis in elderly AML patients.