Abstract 776P
Background
DLBCL is the most common subtype of NHL. There have been reports on vitamin D deficiency(VDD) as a negative prognostic factor in patients with aggressive B cell lymphomas. In this study we aim to look at the baseline Vitamin D level of patients with DLBCL treated with chemoimmunotherapy and to look into its association with treatment response and survival outcome.
Methods
This was a prospective study of patients diagnosed with DLBCL treated in our centre. Serum samples for Vitamin D were collected at the time of diagnosis and was assayed for Vitamin D using Chemo-luminescent assay. A value less than 30ng/ml as deficient and those more than or equal to 30ng/ml as sufficient. Those with deficient vitamin D were graded as critically low (<20ng/ml) and low (20-29ng/ml). Patients were treated with R-CHOP chemoimmunotherapy. End of treatment response (EOT) assessment was done with PET-CT, 6 weeks after completion of treatment and was correlated with baseline vitamin D level. DFS and OS at 1 year was estimated. Survival at 1 year was correlated with baseline vitamin D level.
Results
76 patients were included. The median age was 48 years. There were 35 males and 41 females.M:F ratio was 1:1.17. The most symptom was cervical lymphadenopathy.35% had B symptoms. The Ann Arbor stage was I in 6, II in 21, III in 25, and IV in 24 patients. VDD was seen in 70 (92%) patients. critically low value in 58% and low in 34.2%. 61 patients attained CR, 1 had PR, 8 had progressive disease. Among the 8 with progression 7 had insufficient vitamin D and those with CR; 60 patients had deficient Vitamin D. There was no significant association of Vitamin D level with EOT response.DFS at 1 year was 87.2%. There was no significant difference in DFS with respect to Vitamin D level. Those with critically low , low and normal pretreatment levels of Vitamin D showed no statistical significance in relation to DFS. Overall survival at 1 year was 98%. Among the prognostic variables LDH and extranodal involvement were significant predictors of DFS.
Conclusions
In our study majority of patients (92%) had vitamin D deficiency and among them, more than 50% of patients had a critically low level. No significant difference was observed in the end of treatment response rate and DFS with respect to level and grades of vitamin D.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.