The significance of Serum Vitamin D Levels on Changes in Hematological Parameters After Chemotherapy in Patients with Breast Cancer

Main Article Content

Fatih İnci
Fatih Karataş

Abstract

Objective: To investigate the relationship between serum Vitamin D (VD) level and the change of hematological parameters after chemotherapy in patients with breast cancer (BC) who received adjuvant Adriamycin and Cyclophosphamide (AC).


Material and Methods: A total of 74 BC patients who were treated with adjuvant 60 mg/m2 Adriamycin and 600 mg/m2 Cyclophosphamide (AC) were included in the study. VD levels, complete blood count (CBC) findings after 1st cycle AC were retrospectively recorded. The relationship between changes in CBC parameters according to VD levels and the presence of hematological toxicity was examined.


Results: The mean age was 55.11±9.97 years and the median VD level was 12.78 (4-53.40) ng/mL. In all patient groups, there was a significant decrease in the values of lymphocytes and monocytes after chemotherapy (p=0.030, p=0.024 respectively). In the correlation analysis, there was no correlation between VD levels and hemoglobin levels, the number of cells in CBC-1, and the amount of change in the number of cells in after chemotherapy. However, there was a negative correlation between VD level and platelet/lymphocyte ratio-1 (PLR-1), monocyte/lymphocyte ratio-1 (MLR-1) (p=0.025, r:-0.237; p=0.001, r:-0.370, respectively), but there was no correlation with PLR-2 and MLR-2 (p>0.05 all).


Conclusion: There was no relationship between VD levels and changes in hematological parameters and hematological toxicity related to AC chemotherapy in the patient with BC. VD level was inversely correlated with PLR-1 and MLR-1, which is generally accepted as inflammatory markers. This result showed that the levels of VD do not have a significant role in the development of hematological toxicity after AC chemotherapy in BC.

Downloads

Download data is not yet available.

Article Details

How to Cite
İnci, F., & Karataş, F. (2021). The significance of Serum Vitamin D Levels on Changes in Hematological Parameters After Chemotherapy in Patients with Breast Cancer. Medical Science and Discovery, 8(1), 19-23. https://doi.org/10.36472/msd.v8i1.456
Section
Research Article

References

1. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. The American journal of clinical nutrition. 2004;80(6):1678S-88S.

2. Zhan R, Shen X, Ma Z, Li S, Liang J, Zhang W. Dietary vitamin D intake and risk of non-small cell lung cancer: a matched case-control study. Translational Cancer Research. 2016;5(4):470-5.

3. Medrano M, Carrillo-Cruz E, Montero I, Perez-Simon JA. Vitamin D: effect on haematopoiesis and immune system and clinical applications. International journal of molecular sciences. 2018;19(9):2663.

4. Christakos S, Hewison M, Gardner DG, Wagner CL, Sergeev IN, Rutten E, et al. Vitamin D: beyond bone. Annals of the New York Academy of Sciences. 2013;1287(1):45.

5. Brown G, Kutner A, Marcinkowska E. Vitamin D and Haematopoiesis. Current Tissue Microenvironment Reports. 2020:1-11.

6. Mao X, Hu B, Zhou Z, Xing X, Wu Y, Gao J, et al. Vitamin D levels correlate with lymphocyte subsets in elderly patients with age-related diseases. Scientific reports. 2018;8(1):1-9.

7. Cortes M, Chen MJ, Stachura DL, Liu SY, Kwan W, Wright F, et al. Developmental vitamin D availability impacts hematopoietic stem cell production. Cell reports. 2016;17(2):458-68.

8. Qu X, Tang Y, Hua S. Immunological approaches towards cancer and inflammation: a cross talk. Frontiers in immunology. 2018;9:563.

9. Bellia A, Garcovich C, D’Adamo M, Lombardo M, Tesauro M, Donadel G, et al. Serum 25-hydroxyvitamin D levels are inversely associated with systemic inflammation in severe obese subjects. Internal and emergency medicine. 2013;8(1):33-40.

10. Feldman D, Krishnan AV, Swami S, Giovannucci E, Feldman BJ. The role of vitamin D in reducing cancer risk and progression. Nature reviews cancer. 2014;14(5):342-57.

11. Holick MF. Vitamin D deficiency. New England Journal of Medicine. 2007;357(3):266-81.

12. Larsen ER, Mosekilde L, Foldspang A. Vitamin D and calcium supplementation prevents osteoporotic fractures in elderly community dwelling residents: a pragmatic population‐based 3‐year intervention study. Journal of Bone and Mineral Research. 2004;19(3):370-8.

13. Liu CL, Lee JJ, Liu TP, Chang YC, Hsu YC, Cheng SP. Blood neutrophil‐to‐lymphocyte ratio correlates with tumor size in patients with differentiated thyroid cancer. Journal of surgical oncology. 2013;107(5):493-7.

14. Yucel C, Keskin M, Cakmak O, Ergani B, Kose C, Celik O, et al. Predictive value of pre‐operative inflammation‐based prognostic scores (neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, and monocyte‐to‐eosinophil ratio) in testicular sperm extraction: a pilot study. Andrology. 2017;5(6):1100-4.



15. Jonska-Gmyrek J, Gmyrek L, Zolciak-Siwinska A, Kowalska M, Fuksiewicz M, Kotowicz B. Pretreatment neutrophil to lymphocyte and platelet to lymphocyte ratios as predictive factors for the survival of cervical adenocarcinoma patients. Cancer management and research. 2018;10:6029.

16. Gao Y, Wang WJ, Zhi Q, Shen M, Jiang M, Bian X, et al. Neutrophil/lymphocyte ratio is a more sensitive systemic inflammatory response biomarker than platelet/lymphocyte ratio in the prognosis evaluation of unresectable pancreatic cancer. Oncotarget. 2017;8(51):88835-44.

17. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA: a cancer journal for clinicians. 2011;61(2):69-90.

18. Ahlmann M, Hempel G. The effect of cyclophosphamide on the immune system: implications for clinical cancer therapy. Cancer Chemotherapy and Pharmacology. 2016;78.

19. Ferguson JE, Dodwell DJ, Seymour AM, Richards MA, Howell A. High dose, dose-intensive chemotherapy with doxorubicin and cyclophosphamide for the treatment of advanced breast cancer. British journal of cancer. 1993;67(4):825-9.

20. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism. 2011;96(7):1911-30.

21. Giovannucci E. The epidemiology of vitamin D and cancer incidence and mortality: a review (United States). Cancer causes & control. 2005;16(2):83-95.

22. Crew KD, Shane E, Cremers S, McMahon DJ, Irani D, Hershman DL. High prevalence of vitamin D deficiency despite supplementation in premenopausal women with breast cancer undergoing adjuvant chemotherapy. Journal of Clinical Oncology. 2009;27(13):2151.

23. Hossain S, Beydoun MA, Beydoun HA, Chen X, Zonderman AB, Wood RJ. Vitamin D and breast cancer: A systematic review and meta-analysis of observational studies. Clinical nutrition ESPEN. 2019;30:170-84.

24. Huang Y, Zhou C, Zhao R, Cui Y, Wu X. The relationship between vitamin D, ratio of neutrophil to lymphocyte, and ratio of lymphocyte to monocyte in preoperative serum and prognosis of patients with breast conserving surgery in breast cancer. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE. 2019;12(8):10537-48.

25. Krenn-Pilko S, Langsenlehner U, Thurner EM, Stojakovic T, Pichler M, Gerger A, et al. The elevated preoperative platelet-to-lymphocyte ratio predicts poor prognosis in breast cancer patients. British journal of cancer. 2014;110(10):2524-30.

26. Akbas EM, Gungor A, Ozcicek A, Akbas N, Askin S, Polat M. Vitamin D and inflammation: evaluation with neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio. Archives of medical science: AMS. 2016;12(4):721.

27. Akboga MK, Canpolat U, Yayla C, Ozcan F, Ozeke O, Topaloglu S, et al. Association of platelet to lymphocyte ratio with inflammation and severity of coronary atherosclerosis in patients with stable coronary artery disease. Angiology. 2016;67(1):89-95.

28. Kim DS, Shin D, Lee MS, Kim HJ, Kim DY, Kim SM, et al. Assessments of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in Korean patients with psoriasis vulgaris and psoriatic arthritis. The Journal of dermatology. 2016;43(3):305-10.

29. Narain Niven R, Jimenez Joaquin J, McCook John P, inventors; BERG BIOSYSTEMS LLC, assignee. VITAMIN D3 AND ANALOGS THEREOF FOR ALLEVIATING SIDE EFFECTS ASSOCIATED WITH CHEMOTHERAPY2010 2010/01/27/Application date.


30. Huszno J, Kolosza Z. Prognostic value of the neutrophil‑lymphocyte, platelet‑lymphocyte and monocyte‑lymphocyte ratio in breast cancer patients. Oncology Letters. 2019;18.

31. Kumarasamy C, Sabarimurugan S, Madurantakam RM, Lakhotiya K, Samiappan S, Baxi S, et al. Prognostic significance of blood inflammatory biomarkers NLR, PLR, and LMR in cancer—A protocol for systematic review and meta-analysis. Medicine. 2019;98(24).






































































32. Ni L, Tao J, Xu J, Yuan X, Long Y, Yu N, et al. Prognostic values of pretreatment neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in endometrial cancer: a systematic review and meta-analysis. Archives of gynecology and obstetrics. 2020;301(1):251-61