TITLE:
The Prognostic Value of Vitamin D Insufficiency & Vitamin D Receptor Gene Polymorphism in Adult Acute Myeloid Leukemia Patients
AUTHORS:
Amal Zidan, Alaa Omran, Rania Ghonaim, Fouad Abu-Taleb, Tarek Elgohary
KEYWORDS:
Vitamin D, VDR, FOKI, Polymorphism
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.10 No.5,
May
17,
2019
ABSTRACT: Background: Vitamin D regulates many aspects of cellular growth and differentiation
in normal and cancer cells. There is growing evidence for both serum vitamin D
level and VDR gene polymorphism as prognostic factors in hematologic
malignancies. Aim of this work: Evaluation of vitamin D serum level and
VDR FOKI polymorphism as prognostic factors in adult AML patients. Patients & Methods: Eighty
subjects were included in this study, 50 adult patients with newly diagnosed AML
and 30 apparently healthy controls matched for age and sex. Venous blood
samples were withdrawn from all subjects for measurement of serum 25(OH)
vitamin D using competitive photo chemiluminescence and molecular detection of VDR (FOKI) polymorphism, which was done by RFLP PCR. All patients received the standard
induction chemotherapy regimen 3 & 7. Results: The rate of vitamin
D insufficiency was significantly higher in AML patients compared to controls
(58% vs 16%, p = 0.03). The mutant FOKI genotype (FF & Ff) was found in 52
% of patients compared to 23 % of controls (p = 0.02). Patient with sufficient
vitamin D level showed a significantly higher complete response rate compared
to those with insufficient level (90% vs 44%, p = 0.02), while none of the
other clinical features showed significant relation. Patients with wild type
FOKI polymorphism (FF) were more likely to have favorable cytogenetics, while
patient with mutant FOKI polymorphism were more likely to have poor cytogenetics (p = 0.03). The CR rate was
highest in the wild type FF group (87.5%) followed by the heterozygous Ff group
(50%), while none of the patients in the homozygous ff group achieved CR (p =
0.04). Conclusion: VDR FOKI polymorphism and serum vitamin D level showed a significant
impact on the treatment outcome of adult AML patients suggesting their potential role as
prognostic factors in these patients. Longer follow up will be needed to study
the impact on overall and disease free survival.