ESPE2023 Top 20 Posters Section (20 abstracts)
Hyperparathyroidism is associated with inferior event free survival in lymphatic childhood malignancies in a single center retrospective analysis
Corinna Grasemann 1 , Jakob Höppner 1,2 , Stephan Tippelt 3 , Desiree Grabow 4 , Gunnar Cario 5 , Martin Zimmermann 6 , Dirk Reinhardt 3 & Michael M Schündeln 3
Corinna Grasemann1, Jakob Höppner1,2, Stephan Tippelt3, Desiree Grabow4, Gunnar Cario5, Martin Zimmermann6, Dirk Reinhardt3, Michael M Schündeln3
Introduction: Vitamin D status is investigated as a modifier for the risk and course of multiple malignant diseases. Findings point towards a detrimental role of low vitamin D levels for event free and overall survival (EFS/OS). However, vitamin D deficiency is often associated with secondary hyperparathyroidism, which may influence EFS/OS in childhood malignancies.
Methods: Real world data from 1547 cases (873 male) of childhood malignancies (397 lymphatic) from a single center tertiary university hospital were analyzed. Laboratory data sets with relevance to calcium homeostasis including plasma parathyroid hormone (PTH) and serum 25-OH-vitamin D (25OHD) from 5/2005 – 7/2021 were obtained and filtered for the highest PTH and lowest 25OHD of each patient during the entire observation period. Data on relapse, secondary malignancies and mortality were obtained via chart review; from the national German registry (Kinderkrebsregister) and from the international ALL-BFM study. Data were stratified for the presence/non-presence of hyperparathyroidism (PTH > 65 pg/ml) and the presence/non-presence of a vitamin D deficiency (<30 nmol/L) and EFS/OS of the entire cohort and six disease specific groups was analyzed.
Results: In lymphatic malignancies hyperparathyroidism was associated with inferior EFS (Hazard Ratio (HR) 2.25 [1.38 – 3.66]; OS: HR 1.85 [0.71 – 4.80]), whereas deficient vitamin D levels did not associate with inferior EFS/OS. In the entire cohort and for the other diagnostic strata neither hyperparathyroidism nor vitamin deficiency was associated with inferior EFS/OS.
Conclusion: In childhood lymphatic malignancies, hyperparathyroidism at any time during follow-up is associated with inferior EFS and may mediate the discussed effects of low vitamin D. Further prospective and mechanistic studies on this subject are urgently needed.
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