Research published in the Pakistan Journal of Medical Sciences suggests patients with acute myeloid leukemia and acute lymphoblastic leukemia have lower vitamin D levels during or after chemotherapy compared to before treatment. This study was published last January (2013), but has just finally been indexed into PubMed recently, which is why we are reporting on it now.
To date, there hasn’t been much research looking at the vitamin D levels of newly diagnosed AML and ALL patients when you compare to the amount of literature on the vitamin D levels of nearly diagnosed breast, colon and prostate cancer patients.
Furthermore, there hasn’t been much research looking at the effect of chemotherapy on vitamin D levels. A couple of small studies looking at the effect of chemotherapy on acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) have found no influence of the treatment on vitamin D levels. However, the studies have been small and further investigation is needed.
In the present study, researchers out of Pakistan looked at the vitamin D levels of 86 patients with AML or ALL. The mean age was 24 years old. The researchers divided these patients into four groups, the four groups were:
- AML, before chemotherapy (n=17)
- AML, after chemotherapy initiation (n=13)
- ALL, before chemotherapy (n=31)
- ALL, after chemotherapy initiation (n=25)
The researchers wanted to know if there was a difference in vitamin D levels between before and after treatment. Here’s what they found:
- Vitamin D levels were 17.7 ng/ml in ALL patients yet to have chemotherapy.
- Vitamin D levels were 14.1 ng/ml in ALL patients who had started chemotherapy.
- Vitamin D levels were 19.1 ng/ml in AML patients yet to have chemotherapy.
- Vitamin D levels were 10.6 ng/ml in AML patients who had started chemotherapy.
The difference in vitamin D levels between before chemotherapy and after chemotherapy initiation were statistically significant for both ALL and AML.
The researchers concluded,
“25(OH)D3 insufficiency was evident subnormal in majority of patients with acute leukemia and 25(OH)D3 were further reduced after remission-induction as compared to untreated group, difference was statistically significant when compared with each group.”
A major limitation in this study is that it was case-control by design, so it compared different groups of patients’ vitamin D levels, as opposed to following patients over time. So it’s hard to say if chemotherapy has an effect on vitamin D levels, or if there is something else going on in these groups of patients. A more telling study would be to follow a group of patients before and after chemotherapy and examine their vitamin D levels during treatment, to see if there is an effect.
Future studies should further elucidate the relationship between chemotherapy in ALL and AML and its effect of vitamin D levels.