Researchers studied 80 patients with multiple myeloma (a type of blood cancer) in Singapore to understand how vitamin D and bone health affect their outcomes. They found that nearly 3 out of 4 patients had bone disease when diagnosed, and about 7 out of 10 of those patients had bone-related problems. Surprisingly, most patients weren’t tested for vitamin D levels, and when they were, about 7 out of 10 didn’t have enough. While bone health problems were common, they didn’t directly predict whether patients survived longer or shorter. Instead, the cancer’s stage and whether it affected the kidneys were better predictors of survival.

The Quick Take

  • What they studied: Whether vitamin D levels and bone disease in multiple myeloma patients affect how long they survive and how well they do
  • Who participated: 80 patients newly diagnosed with multiple myeloma (a cancer of blood cells) in Singapore between 2018 and 2022, including patients of different ages and backgrounds
  • Key finding: About 74% of patients had bone disease at diagnosis, and nearly 7 out of 10 of those had bone-related problems. However, bone disease didn’t predict survival—the cancer’s stage and kidney involvement were more important
  • What it means for you: If you or a loved one has multiple myeloma, bone health monitoring is important for quality of life, but survival depends more on the cancer’s stage and how it affects other organs. Vitamin D testing should be routine, as most patients were deficient

The Research Details

This was a retrospective cohort study, which means researchers looked back at medical records from patients already treated between 2018 and 2022. They collected information about 80 patients with newly diagnosed multiple myeloma, including their vitamin D levels, bone health, and how they were treated. The researchers then compared outcomes between patients who survived and those who didn’t using statistical tests. They used special analysis methods (Kaplan-Meier curves and Cox Regression) to understand which factors most strongly predicted survival.

This study design allows researchers to identify patterns in real-world patient care without needing to wait years for results. By looking at actual patient outcomes, they could see which health factors truly matter for survival and which are just common side effects of the cancer.

The study included a reasonable number of patients (80) and used appropriate statistical methods. However, it was conducted in one medical center in Singapore, so results may not apply equally to all populations. The researchers collected complete data on most patients, though not all had vitamin D testing, which limits some conclusions. The study’s retrospective nature means some information may have been incomplete or recorded differently over time.

What the Results Show

Nearly 3 out of 4 patients (74%) had bone disease when first diagnosed with multiple myeloma. Among those with bone disease, about 7 out of 10 (71%) experienced bone-related problems like fractures or pain at diagnosis. When researchers looked at survival, they found that having bone disease didn’t predict whether patients lived longer or shorter—this was surprising because bone disease is so common in this cancer. Instead, the cancer’s stage (measured by R-ISS scoring) was the strongest predictor of survival. Patients with stage 3 cancer had nearly 4 times higher risk of death compared to earlier stages.

Vitamin D testing was not done routinely—only 70 of 80 patients had their levels checked at diagnosis. Of those tested, about 7 out of 10 (69%) had insufficient or deficient vitamin D levels. Patients who weren’t Chinese had higher early mortality rates compared to Chinese patients, though this difference disappeared when researchers adjusted for cancer stage. Kidney involvement at diagnosis was also associated with higher mortality.

Previous research suggested bone disease in multiple myeloma might affect survival, but this study found no direct connection. This suggests that while bone disease causes real suffering and complications, it may not be the main factor determining how long patients survive. The finding that cancer stage is most important aligns with other research showing that how advanced the cancer is matters most for outcomes.

The study was small (80 patients) and conducted in one hospital in Singapore, so results may not apply to all populations worldwide. Not all patients had vitamin D testing, making it hard to fully understand vitamin D’s role. The study looked backward at medical records, so some information may have been recorded inconsistently. The researchers couldn’t determine cause-and-effect relationships, only associations between factors and outcomes.

The Bottom Line

If you have multiple myeloma: (1) Get your vitamin D levels tested and maintain adequate levels through supplementation if needed—this supports bone health and overall wellness, even if it doesn’t directly affect survival; (2) Focus on cancer treatment based on your stage and risk factors, as these are the strongest predictors of outcomes; (3) Work with your care team on bone health management to prevent fractures and pain, which significantly affect quality of life. Confidence level: Moderate for bone health importance, High for cancer stage importance.

Multiple myeloma patients and their families should care about these findings. Oncologists should ensure routine vitamin D testing and supplementation. Patients with advanced cancer stages should discuss prognosis and treatment intensity with their doctors. This is less relevant for people without multiple myeloma, though the vitamin D findings may have broader health implications.

Vitamin D supplementation effects on bone health may take 3-6 months to show measurable improvement. Cancer survival outcomes depend on treatment response, which varies widely but is typically assessed within 2-3 months of starting treatment.

Want to Apply This Research?

  • Track vitamin D supplementation daily and bone health symptoms weekly (bone pain level 0-10, any new fractures or falls, mobility changes). Log these alongside treatment dates and cancer staging information.
  • Set a daily reminder to take vitamin D supplements as prescribed. Schedule monthly check-ins to review bone health symptoms and report any new pain or mobility issues to your care team.
  • Create a monthly summary showing vitamin D supplement adherence, bone pain trends, and any skeletal-related events. Share this with your oncology team during appointments to optimize bone health management alongside cancer treatment.

This research describes patterns in one group of patients and should not be used for self-diagnosis or treatment decisions. Multiple myeloma is a serious condition requiring specialized medical care. If you have been diagnosed with multiple myeloma or have concerns about bone health, consult with your oncologist or hematologist before making any changes to your treatment or supplementation. Vitamin D supplementation should only be started under medical supervision, as excessive intake can be harmful. This summary is for educational purposes and does not replace professional medical advice.