Multiple Myeloma Coverage from Every Angle

Vitamin D Deficiency and Racial Differences in Disease Biology in Multiple Myeloma

By: Joshua D. Madera, MS
Posted: Monday, August 3, 2020

Vitamin D deficiency may lead to an increased risk for multiple myeloma in white patients—but apparent not in Black patients—according to a population-based study published in Blood Advances. In addition, even after investigators adjusted for age and disease stage, the deficiency in vitamin D seemed to be prognostic for poor overall survival.

“With the known association between bone marrow microenvironment, especially the bone elements, and multiple myeloma cell growth and survival, vitamin D may play a unique role in multiple myeloma compared with other cancers,” reported Nikhil C. Munshi, MD, of Dana-Farber Cancer Institute, Boston, and colleagues.

A total of 1,889 white (n = 1,158) and Black (n = 551) patients with multiple myeloma who were registered in the Veteran Affairs nationwide database were enrolled in the study. Patients’ vitamin D serum levels were measured, and those with levels less than 20 ng/mL were considered vitamin D–deficient. The deficiency was assessed across race, sex, International Staging System stage at diagnosis, initial myeloma therapy, and transplant status. Dr. Munshi and colleagues aimed to determine the survival outcome of vitamin D deficiency in patients with multiple myeloma.

The investigators found an overall estimated mortality risk of 24% in patients with a vitamin D deficiency. When analyzed by race, they found an increased mortality risk of 38% among white patients. These findings suggest that vitamin D deficiency may be a positive predictor of survival in white patients. However, there was no statistically significant difference among Black patients, even when the vitamin D deficiency threshold was reduced to 10 ng/mL.

“We hypothesize our findings of disparate effect of vitamin D deficiency relate to increased cancer (myeloma)-related mortality in white vs [Black] patients rather than comorbidities,” Dr. Munshi and colleagues concluded.

Disclosure: For full disclosures of the authors, visit

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