By: Kerri Fitzgerald
A study found that low baseline vitamin D is associated with poor prognosis in patients with diffuse large B-cell lymphoma (DLBCL); however, supplementation with vitamin D did not improve outcomes for these patients.
Tanja Lazic, MD, of Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia in Italy, presented the study as part of the 18th International Conference on Malignant Lymphoma in Lugano, Switzerland.
The study included patients with newly diagnosed DLBCL who were 65 years or older and had 25(OH)VitD levels <40 ng/mL. Patients (n=314) were randomized to receive:
- Arm A: prephase prednisone 50 mg for 7 days and no supplementation of vitamin D (n=156)
- Arm B: prephase prednisone 50 mg for 7 days plus vitamin D 25,000 U/day for 7 to 14 days depending on baseline levels, followed by maintenance vitamin D 25,000 U/day through the end of immunochemotherapy (n=158)
Patients then went on to receive R-CHOP, R-COMP, or other chemotherapy regimens.
The median follow-up was 16 months, and progression-free survival (PFS; primary endpoint) was evaluable in 307 patients. Median patient age was 76 years, and nearly half of patients (49.4%) were intermediate risk, per the Elderly Prognostic Index (EPI).
The estimated two-year PFS was 65% in arm A and 58% in arm B (P=0.260). Estimated 2-year PFS based on baseline vitamin D level was 68% for vitamin D >16 ng/mL and 58% for vitamin d <16 ng/mL.
The researchers found that EPI was “a robust tool for identifying high-risk elderly patients.” The hazard ratio for 2-year PFS stratified by EPI risk category was 2.56 (P=0.004).
Dr. Lazic discusses the results in this audio clip from ICML.
Reference
Merli F, Lazic T, Tucci A, et al. Prephase treatment with vitamin D supplementation in older patients with diffuse large B-cell lymphoma (DLBCL): a randomized trial by Fondazione Italiana Linfomi (FIL). Abstract #277. Presented at the 18th International Conference on Malignant Lymphoma; June 17-21, 2025; Lugano, Switzerland.
Check out more our coverage from ICML!
