Prevalence of Vitamin D Deficiency in Newly Diagnosed Multiple Myeloma Patients: Vitamin D in Myeloma Patients

Rija Shadab Rizvi; Syeda Mah Ali; Naila Raza; Sidra Dawood; Shehla Parveen

doi:10.54393/pjhs.v6i5.2950

Authors

Rija Shadab Rizvi Department of Hematology, Liaquat National Hospital, Karachi, Pakistan
Syeda Mah Ali Department of Hematology, Liaquat National Hospital, Karachi, Pakistan
Naila Raza Department of Hematology, Liaquat National Hospital, Karachi, Pakistan
Sidra Dawood Department of Hematology, Liaquat National Hospital, Karachi, Pakistan
Shehla Parveen Department of Hematology, Liaquat National Hospital, Karachi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i5.2950

Keywords:

Multiple Myeloma, Vitamin D Deficiency, 25-Hydroxyvitamin D, Skeletal Complications

Abstract

Multiple Myeloma (MM) is a plasma cell disorder with skeletal complications. Vitamin D deficiency may contribute to these complications. Objective: To check vitamin D levels and determine the prevalence of Vitmain D deficiency in newly diagnosed MM patients. Methods: A prospective cross-sectional study was conducted from July 2024 till February 2025 at Liaquat National Hospital, Karachi, including 85 newly diagnosed MM patients. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured. Demographic and laboratory data, including hemoglobin, calcium, creatinine, LDH, uric acid, and serum protein electrophoresis, were collected. Blood samples for vitamin D analysis were collected in red-top tubes. All the data analysis was done by IBM SPSS Version 22.0. Results: A total of 85 newly diagnosed MM patients (mean age: 55 ± 8.6 years) were evaluated for vitamin D deficiency. Males comprised 54 (63.5%) patients, while females accounted for 31 (36.5%). The mean vitamin D level was 21.79 ± 7.2ng/mL. 56 (65.9%) of the patients had Vitamin D deficiency (<20ng/mL), 22 (25.9%) had insufficiency (20–29ng/mL), and only 7 (8.2%) had sufficient levels (≥30ng/mL). Urban residents had significantly lower vitamin D levels than rural residents (p = 0.03). Conclusions: Vitamin D insufficiency was prevalent in newly diagnosed MM patients and may contribute to skeletal complications. Variations in vitamin D levels based on patient residence suggest further investigation into potential contributing factors.

References

Cashman KD. Vitamin D deficiency: defining, prevalence, causes, and strategies of addressing. Calcified Tissue International. 2020 Jan; 106(1): 14-29. doi: 10.1007/s00223-019-00559-4.

Siddiqee MH, Bhattacharjee B, Siddiqi UR, MeshbahurRahman M. High prevalence of vitamin D deficiency among the South Asian adults: a systematic review and meta-analysis. BioMed Central Public Health. 2021 Dec; 21: 1-8. doi: 10.1186/s12889-021-11888-1.

Seamans KM and Cashman KD. Existing and potentially novel functional markers of vitamin D status: a systematic review234. The American Journal of Clinical Nutrition. 2009 Jun; 89(6): 1997S-2008S. doi: 10.3945/ajcn.2009.27230D.

Shafia S, Qasim I, Aziz SA, Bhat IA, Nisar S, Shah ZA. Role of vitamin D receptor (VDR) polymorphisms in susceptibility to multiple myeloma in ethnic Kashmiri population. Blood Cells, Molecules, and Diseases. 2013 Jun; 51(1): 56-60. doi: 10.1016/j.bcmd.2013.02.001.

Kelly JL, Salles G, Goldman B, Fisher RI, Brice P, Press O et al. Low serum vitamin D levels are associated with inferior survival in follicular lymphoma: a prospective evaluation in SWOG and LYSA studies. Journal of Clinical Oncology. 2015 May; 33(13): 1482-90. doi: 10.1200/JCO.2014.57.5092.

Buttigliero C, Monagheddu C, Petroni P, Saini A, Dogliotti L, Ciccone G et al. Prognostic role of vitamin d status and efficacy of vitamin D supplementation in cancer patients: a systematic review. The Oncologist. 2011 Sep; 16(9): 1215-27. doi: 10.1634/theoncologist.2011-0098.

Drake MT, Maurer MJ, Link BK, Habermann TM, Ansell SM, Micallef IN et al. Vitamin D insufficiency and prognosis in non-Hodgkin's lymphoma. Journal of Clinical Oncology. 2010 Sep; 28(27): 4191-8. doi: 10.1200/JCO.2010.28.6674.

Kumar R, Gupta N, Singh V, Kumar V, Haq A, Mirza AA et al. Unveiling molecular associations of polymorphic variants of VDR gene (FokI, BsmI and ApaI) in multiple myeloma patients of Indian population. The Journal of Steroid Biochemistry and Molecular Biology. 2020 May; 199: 105588. doi: 10.1016/j.jsbmb.2020.105588.

Ismail NH, Mussa A, Al-Khreisat MJ, Mohamed Yusoff S, Husin A, Johan MF et al. The global prevalence of vitamin D deficiency and insufficiency in patients with multiple myeloma: A systematic review and meta-analysis. Nutrients. 2023 Jul; 15(14): 3227. doi: 10.3390/nu15143227.

Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA: a Cancer Journal for Clinicians. 2024 Jan; 74(1): 12-49. doi: 10.3322/caac.21820.

Valle HB, Yaktine AL, Taylor CL, Ross AC, editors. Dietary reference intakes for calcium and vitamin D. 2011. doi: 10.17226/13050.

Millen BE, Abrams S, Adams-Campbell L, Anderson CA, Brenna JT, Campbell WW et al. The 2015 dietary guidelines advisory committee scientific report: development and major conclusions. Advances in nutrition. 2016 May; 7(3): 438-44. doi: 10.3945/an.116.012120.

Graklanov V, Popov V, Raycheva R. Serum levels of vitamin D in patients with multiple myeloma. Folia Medica. 2020 Dec; 62(4): 730-5. doi: 10.3897/folmed.62.e50321.

Sfeir JG, Drake MT, LaPlant BR, Maurer MJ, Link BK, Berndt TJ et al. Validation of a vitamin D replacement strategy in vitamin D-insufficient patients with lymphoma or chronic lymphocytic leukemia. Blood Cancer Journal. 2017 Feb; 7(2): e526-. doi: 10.1038/bcj.2017.9.

Sincan G and Erdem F. The effects of vitamin D level on bone lesions and prognostic factors in multiple myeloma. Meandros Medical and Dental Journal. 2021 Aug; 22(2): 196. doi: 10.4274/meandros.galenos.2021.94557.

Lauter B and Schmidt-Wolf IG. Prevalence, supplementation, and impact of vitamin D deficiency in multiple myeloma patients. Cancer Investigation. 2015 Nov; 33(10): 505-9. doi: 10.3109/07357907.2015.1081690.

Clement Z, Ashford M, Sivakumaran S. Vitamin D deficiency in a man with multiple myeloma. North American Journal of Medical Sciences. 2011 Oct; 3(10): 469. doi: 10.4297/najms.2011.3469.

Isoda A, Miyazawa Y, Ishikawa T, Kanaya S, Nakayama K, Mihara M et al. Prevalence and clinical outcomes of vitamin D deficiency among Japanese multiple myeloma patients: a single-center observational study. Supportive Care in Cancer. 2023 Sep; 31(9): 547. doi: 10.1007/s00520-023-08021-w.

Wang J, Udd KA, Vidisheva A, Swift RA, Spektor TM, Bravin E et al. Low serum vitamin D occurs commonly among multiple myeloma patients treated with bortezomib and/or thalidomide and is associated with severe neuropathy. Supportive Care in Cancer. 2016 Jul; 24: 3105-10. doi: 10.1007/s00520-016-3126-1.

Oortgiesen BE, Dekens M, Stapel R, Alheraky A, Dannenberg PD, Siemes C et al. Effectiveness of a vitamin D regimen in deficient multiple myeloma patients and its effect on peripheral neuropathy. Supportive Care in Cancer. 2023 Feb; 31(2): 138. doi: 10.1007/s00520-023-07574-0.

Afonso ML, Capelas ML, Pimenta NM, Santos T, Mäkitie A, Ganhão-Arranhado S et al. A Systematic Review of Vitamin D Supplementation in Oncology: Chance of Science or Effectiveness?. Nutrients. 2025 Feb; 17(4): 634. doi: 10.3390/nu17040634.

Bouillon R, Manousaki D, Rosen C, Trajanoska K, Rivadeneira F, Richards JB. The health effects of vitamin D supplementation: evidence from human studies. Nature Reviews Endocrinology. 2022 Feb; 18(2): 96-110. doi: 10.1038/s41574-021-00593-z.

Rui H, Liu Y, Lin M, Zheng X. Vitamin D receptor gene polymorphism is associated with multiple myeloma. Journal of Cellular Biochemistry. 2020 Jan; 121(1): 224-30. doi 10.1002/jcb.29135.

Mirhosseini N, Psihogios A, McLaren MD, Seely D. Vitamin D and multiple myeloma: a scoping review. Current Oncology. 2023 Mar; 30(3): 3263-76. doi: 10.3390/curroncol30030248.