Vitamin D and Leukemia

Leukemia

Leukemia is a cancer of the blood or bone marrow. The disease causes an abnormal increase of white blood cells. There are many types of leukemia. Each year, leukemia affects approximately 45,000 people in the United States and kills 22,000.

Risk factors

Risk factors for some types of leukemia include:

• Chemicals in the environment (benzene, which comes from gasoline, and pesticides)
• Smoking
• Eating red meat
• Viral infections

Sunlight exposure and leukemia risk

There is some evidence that solar ultraviolet-B (UVB) light reduces the risk of leukemia:

• One paper reported fewer leukemia deaths at altitudes above 2000 feet. UVB levels increase at higher altitudes.
• In the United Kingdom, childhood leukemia has been linked to infections in the winter.
• A study of United Arab Emirates (UAE) natives found a higher rate of acute lymphoblastic leukemia among females than males. This is the opposite of what is found in other countries. This finding may be due to the clothing that UAE females wear. Their skin is covered from the sun. As a result, they may have lower vitamin D levels.
• A multi-country study found leukemia incidence rates increased with distance from the equator. At higher latitudes, solar UVB doses are lower.

Vitamin D and leukemia

Vitamin D levels

The Harvard Health Professionals Follow-up Study noted a direct link between vitamin D and leukemia rate. People in the highest vitamin D group had a 56% reduction in leukemia compared to those in the lowest group. However, only 82 people developed leukemia, which is a small sample size.

How vitamin D works

Vitamin D may lower the risk of some types of leukemia by:

• Strengthening the immune system to fight viral infections.
• Control of cellular growth such that cells either adapt to the organ they are in or disintegrate.

Prevention

While the evidence is modest, higher vitamin D levels may prevent some types of leukemia. Higher vitamin D levels might help lower infections in the winter, and, thus, the risk of leukemia.

Treatment

People with chronic lymphocytic leukemia and higher vitamin D levels had 50% lower disease progression and survival rates. People with this form of leukemia may have a better outcome with vitamin D supplements.

Acknowledgements

William B. Grant, Ph.D.
Sunlight, Nutrition, and Health Research Center (SUNARC)
P.O. Box 641603
San Francisco, CA 94164-1603, USA
www.sunarc.org
wbgrant@infionline.net

References

1. Abe, E. Miyaura, C. Sakagami, H. Takeda, M. Konno, K. Yamazaki, T. Yoshiki, S. Suda, T. Differentiation of mouse myeloid leukemia cells induced by 1 alpha,25-dihydroxyvitamin D3. Proc Natl Acad Sci U S A. 1981 Aug; 78 (8): 4990-4.
2. Beane Freeman, L. E. Bonner, M. R. Blair, A. Hoppin, J. A. Sandler, D. P. Lubin, J. H. Dosemeci, M. Lynch, C. F. Knott, C. Alavanja, M. C. Cancer incidence among male pesticide applicators in the Agricultural Health Study cohort exposed to diazinon. Am J Epidemiol. 2005 Dec 1; 162 (11): 1070-9.
3. Blair, A. Zheng, T. Linos, A. Stewart, P. A. Zhang, Y. W. Cantor, K. P. Occupation and leukemia: a population-based case-control study in Iowa and Minnesota. Am J Ind Med. 2001 Jul; 40 (1): 3-14.
4. Bonner, M. R. Williams, B. A. Rusiecki, J. A. Blair, A. Beane Freeman, L. E. Hoppin, J. A. Dosemeci, M. Lubin, J. Sandler, D. P. Alavanja, M. C. Occupational exposure to terbufos and the incidence of cancer in the Agricultural Health Study. Cancer Causes Control. 2010 Jun; 21 (6): 871-7.
5. Boscoe, F. P. Schymura, M. J. Solar ultraviolet-B exposure and cancer incidence and mortality in the United States, 1993-2002. BMC Cancer. 2006; 6264.
6. Cannell, J. J. Vieth, R. Umhau, J. C. Holick, M. F. Grant, W. B. Madronich, S. Garland, C. F. Giovannucci, E. Epidemic influenza and vitamin D. Epidemiol Infect. 2006 Dec; 134 (6): 1129-40.
7. Cannell, J. J. Zasloff, M. Garland, C. F. Scragg, R. Giovannucci, E. On the epidemiology of influenza. Virol J. 2008; 529.
8. Chen, W. Clements, M. Rahman, B. Zhang, S. Qiao, Y. Armstrong, B. K. Relationship between cancer mortality/incidence and ambient ultraviolet B irradiance in China. Cancer causes & control : CCC. 2010 Oct; 21 (10): 1701-9.
9. Clavel, J. Hemon, D. Mandereau, L. Delemotte, B. Severin, F. Flandrin, G. Farming, pesticide use and hairy-cell leukemia. Scand J Work Environ Health. 1996 Aug; 22 (4): 285-93.
10. Devesa, S. S. Grauman, D. J. Blot, W. J. Pennello, G. A. Hoover, R. N. Fraumeni, J. F. Jr. Atlas of Cancer Mortality in the United States, 1950-1994. NIH Publication No. 99-4564. 1999 April 17, 2010;
11. Eckhoff, N. D. Shultis, J. K. Clack, R. W. Ramer, E. R. Correlation of leukemia mortality rates with altitude in the United States. Health Phys. 1974 Oct; 27 (4): 377-80.
12. Gao, F. Chia, K. S. Machin, D. On the evidence for seasonal variation in the onset of acute lymphoblastic leukemia (ALL). Leukemia research. 2007 Oct; 31 (10): 1327-38.
13. Gao, F. Nordin, P. Krantz, I. Chia, K. S. Machin, D. Variation in the seasonal diagnosis of acute lymphoblastic leukemia: evidence from Singapore, the United States, and Sweden. American journal of epidemiology. 2005 Oct 15; 162 (8): 753-63.
14. Garay, E. Donnelly, R. Wang, X. Studzinski, G. P. Resistance to 1,25D-induced differentiation in human acute myeloid leukemia HL60-40AF cells is associated with reduced transcriptional activity and nuclear localization of the vitamin D receptor. J Cell Physiol. 2007 Dec; 213 (3): 816-25.
15. Giovannucci, E. Liu, Y. Rimm, E. B. Hollis, B. W. Fuchs, C. S. Stampfer, M. J. Willett, W. C. Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. J Natl Cancer Inst. 2006 Apr 5; 98 (7): 451-9.
16. Grant, W. B. Cancer risk ecological study in Rhineland-Palatinate, Germany, provides strong support for the ultraviolet B-vitamin D-cancer hypothesis. J Occup Med Toxicol. 2010 19 July 2010; 19 July 2010
17. Grant, W. B. Garland, C. F. The association of solar ultraviolet B (UVB) with reducing risk of cancer: multifactorial ecologic analysis of geographic variation in age-adjusted cancer mortality rates. Anticancer Res. 2006 Jul-Aug; 26 (4A): 2687-99.
18. Hassan, I. B. Islam, S. I. Alizadeh, H. Kristensen, J. Kambal, A. Sonday, S. Bernseen, R. M. Acute leukemia among the adult population of United Arab Emirates: an epidemiological study. Leuk Lymphoma. 2009 Jul; 50 (7): 1138-47.
19. Hughes, P. J. Marcinkowska, E. Gocek, E. Studzinski, G. P. Brown, G. Vitamin D3-driven signals for myeloid cell differentiation–implications for differentiation therapy. Leuk Res. 2010 May; 34 (5): 553-65.
20. Khalade, A. Jaakkola, M. S. Pukkala, E. Jaakkola, J. J. Exposure to benzene at work and the risk of leukemia: a systematic review and meta-analysis. Environ Health. 2010; 931.
21. Kroll, M. E. Draper, G. J. Stiller, C. A. Murphy, M. F. Childhood leukemia incidence in Britain, 1974-2000: time trends and possible relation to influenza epidemics. J Natl Cancer Inst. 2006 Mar 15; 98 (6): 417-20.
22. Marcinkowska, E. Gocek, E. Heat shock protein 90 interacts with vitamin D receptor in human leukemia cells. J Steroid Biochem Mol Biol. 2010 Jul; 121 (1-2): 114-6.
23. Mohr SB, Garland CF, Gorham ED, Grant WB, Garland FC. Ultraviolet B and incidence rates of leukemia worldwide. Am J Prev Med. 2011 Jul; 41 (1): 68-74.
24. Seidler, A. Hammer, G. P. Husmann, G. Konig, J. Krtschil, A. Schmidtmann, I. Blettner, M. Cancer risk among residents of Rhineland-Palatinate winegrowing communities: a cancer-registry based ecological study. J Occup Med Toxicol. 2008; 312.
25. Shanafelt, T. D. Drake, M. T. Maurer, M. J. Allmer, C. Rabe, K. G. Slager, S. L. Weiner, G. J. Call, T. G. Link, B. K. Zent, C. S. Kay, N. E. Hanson, C. A. Witzig, T. E. Cerhan, J. R. Vitamin D insufficiency and prognosis in chronic lymphocytic leukemia (CLL). Blood. 2010 Nov 3;
26. Sorensen, H. T. Pedersen, L. Olsen, J. Rothman, K. Seasonal variation in month of birth and diagnosis of early childhood acute lymphoblastic leukemia. JAMA. 2001 Jan 10; 285 (2): 168-9.
27. Timonen, T. Nayha, S. Koskela, T. Pukkala, E. Are sunlight deprivation and influenza epidemics associated with the onset of acute leukemia?. Haematologica. 2007 Nov; 92 (11): 1553-6.
28. Timonen, T. T. A hypothesis concerning deficiency of sunlight, cold temperature, and influenza epidemics associated with the onset of acute lymphoblastic leukemia in northern Finland. Ann Hematol. 1999 Sep; 78 (9): 408-14.
29. Van Maele-Fabry, G. Lantin, A. C. Hoet, P. Lison, D. Residential exposure to pesticides and childhood leukaemia: a systematic review and meta-analysis. Environ Int. 2011 Jan; 37 (1): 280-91.