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Prognostic value of 25-hydroxy vitamin D in extranodal NK/T cell lymphoma

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Abstract

25-hydroxy vitamin D [25-(OH)D] is widely used to determine vitamin D status in clinic. The aim of our study was to evaluate the prognostic value of 25-(OH)D in extranodal NK/T cell lymphoma (ENKTL). Ninety-three (93) ENKTL patients with available serum 25-(OH)D values were enrolled in our study. Vitamin D deficiency is defined as a 25-(OH)D below 50 nmol/L (20 ng/ml). Univariate and multivariate regression analyses were performed to determine independent risk factors for progression-free survival (PFS) and overall survival (OS). Receiver operator characteristic (ROC) curves were plotted, and corresponding areas under the curves (AUC) were calculated to estimate the accuracy of PINK-E (prognostic index of natural killer lymphoma added with Epstein-Barr virus-DNA status) and 25-(OH)D deficiency in ENKTL risk-stratification. Our results suggested that the vitamin D deficiency was an independent inferior prognostic factor for both PFS [hazard ratio (HR), 2.869; 95% confidence interval (CI), 1.540 to 5.346; P = 0.003] and OS (HR, 3.204; 95% CI, 1.559 to 6.583; P = 0.006) in patients with ENKTL. Additionally, we demonstrated that adding 25-(OH)D deficiency to PINK-E score system indeed has a superior prognostic significance than PINK-E alone for PFS [AUC: 0.796 (95% CI: 0.699 to 0.872) vs. 0.759 (95% CI: 0.659 to 0.841), P = 0.020] and OS [AUC: 0.755 (95% CI: 0.655 to 0.838) vs. 0.721 (95% CI: 0.618 to 0.809), P = 0.040]. In conclusion, our study proved that 25-(OH)D deficiency was associated with inferior survival outcome of ENKTL patients.

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Funding

This study was supported by National Natural Science Foundation of China (81770166, 81720108002), Jiangsu Province’s Medical Elite Programme (ZDRCA2016022), Project of National Key Clinical Specialty, Jiangsu Provincial Special Program of Medical Science (BE2017751), and National Science and Technology Major Project (2018ZX09734007).

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  1. Jin Mao and Hua Yin contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China

    Jin Mao, Hua Yin, Li Wang, Jia-Zhu Wu, Yi Xia, Hua-Yuan Zhu, Lei Fan, Jian-Yong Li, Jin-Hua Liang & Wei Xu

  2. Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China

    Jin Mao, Hua Yin, Li Wang, Jia-Zhu Wu, Yi Xia, Hua-Yuan Zhu, Lei Fan, Jian-Yong Li, Jin-Hua Liang & Wei Xu

  3. Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China

    Jin Mao, Hua Yin, Li Wang, Jia-Zhu Wu, Yi Xia, Hua-Yuan Zhu, Lei Fan, Jian-Yong Li, Jin-Hua Liang & Wei Xu

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  1. Jin Mao
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Contributions

JM and WX designed the experiment. JM, HY, LW, HYZ, JHL, YX, JZW, and LF organized the clinical materials. JM, HY, WX, and JYL performed the data analysis and wrote the paper. All authors contributed to the interpretation of the data, critically revised the article throughout development for intellectual content, approved the final version and are accountable for the accuracy and integrity of the work.

Corresponding authors

Correspondence to Jin-Hua Liang or Wei Xu.

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The study was approved by the Ethics Committee of the First Affiliated Hospital of Nanjing Medical University. All subjects provided written informed consent according to the Declaration of Helsinki.

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Mao, J., Yin, H., Wang, L. et al. Prognostic value of 25-hydroxy vitamin D in extranodal NK/T cell lymphoma. Ann Hematol 100, 445–453 (2021). https://doi.org/10.1007/s00277-020-04320-y

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