A study recently published in Plos One reports that vitamin D and the drug deferasirox may help increase length of survival in elderly patients with acute myeloid leukemia (AML).
The researchers, led by Dr Etienne Paubelle of Paris Descartes University, administered deferasirox (1-2 g/day) and 100,000 IU of 25(OH)D/week in 17 patients with AML.
AML describes a group of cancers characterized by uncontrolled white blood cell growth. The most common therapy is chemotherapy, resulting in 40 to 60% success rate in remitting the cancer after treatment. In this study, the researchers wanted to look at AML patients whose cancer had either relapsed after chemotherapy or were unfit for chemotherapy, likely due to their old age and poor health.
Deferasirox is an iron chelator, shown in cell culture studies to induce AML cell death, aiding in slowing down the uncontrolled cell growth. In these type of studies, it works by inhibiting the “NF-κB pathway.” The same group of researchers also have found that vitamin D promotes cell differentiation, and they have found that iron chelating agents may work synergistically with vitamin D in these studies.
In the present study, the researchers administered deferasirox and vitamin D to 17 patients and compared them to 13 controls with AML as well. The controls received best supportive care (BSC), a generic description for providing medical care without any interventions intended to treat or cure the cancer. Again, both groups were in the same boat in that chemotherapy was no longer an option and passing was imminent.
Here’s what the researchers found when comparing the deferasirox-vitamin D group and the BSC group:
- Those who received the deferasirox-vitamin D therapy survived for a median 10.4 months compared to the BSC group surviving a median 4 months.
- Baseline vitamin D level strongly predicted length of survival, while no other marker they measured predicted survival.
- At baseline, those with vitamin D levels greater than 20 ng/ml survived a median 21 months, while those with levels less than 20 ng/ml only survived 7 months.
Currently, the average length of survival in elderly patients with AML is 4 months, a finding that was replicated in the group that received basic standard care. Any therapy that could prolong survival would be welcome. While this experimental therapy is intriguing, the researchers warn that further research must be carried out.
The authors conclude, “These encouraging results from this retrospective study should… be verified in a large randomized prospective multicenter study.”
Paubelle E, Zylbersztejn F, Alkhaeir S, Suarez F, Callens C, et al. (2013) Deferasirox and Vitamin D Improves Overall Survival in Elderly Patients with Acute Myeloid Leukemia after Demethylating Agents Failure. PLoS ONE 8(6): e65998. doi:10.1371/journal.pone.0065998