25-hydroxy vitamin D levels in patients with myelofibrosis and potential relationships with disease severity: A case-control study

Abstract

Background/Aim: Although vitamin D deficiency has been associated with cancer and its prognosis, data is unclear regarding associations with myelofibrosis. This study aimed to measure 25-hydroxy vitamin D levels in patients with myelofibrosis and to evaluate its relationship with prognoses. Methods: This case-control study consisted of 72 patients with myelofibrosis and 75 controls. The Dynamic International Prognostic Scoring System was used to determine prognostic risk groups, and patients were divided into two subgroups: intermediate-1 (low risk) and intermediate-2 (high risk). Results: The median 25-OHD levels were decreased in the myelofibrosis group more so than in the controls (13.05 vs. 23.0 ng/mL, P<0.001). A cut-off value of ≤ 16.5 ng/mL yielded a sensitivity of 84.72% and a specificity of 80% for the identification of patients with myelofibrosis. This impact was also evident when adjusted for age and sex, showing that patients with low 25-hydroxy vitamin D (≤16.5) had a 23.787-fold higher probability to have myelofibrosis (OR: 23.787, 95% CI: 9.676-58.479, P<0.001). When examined for the two prognostic subgroups, 25-hydroxy vitamin D was found to be significantly lower in the intermediate-2 and high subgroup (P=0.017). For a cut-off value of ≤13.7 ng/mL, 25-hydroxy vitamin D level was able to discriminate patients in the intermediate-2 and high subgroup from those with lower risk (sensitivity: 77.8%, specificity: 55.6%). Conclusion: A serum 25-hydroxy vitamin D level may serve as a biomarker associated with myelofibrosis diagnosis and prognosis; however, the discriminatory value for prognostic groups was low, indicating the need for larger and longitudinally-designed studies.