Researchers studied 90 children to understand the connection between vitamin D and a common childhood cancer called acute lymphoblastic leukemia (ALL). They found that over 8 out of 10 children with ALL had dangerously low vitamin D levels compared to healthy children. The study also looked at a protein called the vitamin D receptor that helps our bodies use vitamin D. While the findings suggest vitamin D deficiency is common in children with ALL, scientists say more research is needed to understand if giving vitamin D supplements could help treat this disease.

The Quick Take

  • What they studied: Whether children with a blood cancer called acute lymphoblastic leukemia (ALL) have lower vitamin D levels than healthy children, and how this connects to a protein that helps bodies use vitamin D
  • Who participated: 90 children in Indonesia divided into three groups: 30 with standard-risk ALL, 30 with high-risk ALL, and 30 healthy children without cancer
  • Key finding: About 82% of children with ALL had vitamin D deficiency, with levels around 13-14 ng/mL compared to 19.6 ng/mL in healthy children. This difference was statistically significant (P<0.001), meaning it’s very unlikely to happen by chance
  • What it means for you: If your child has been diagnosed with ALL, doctors may want to check their vitamin D levels and consider supplements. However, this study doesn’t prove that vitamin D supplements can treat leukemia—more research is needed before making treatment decisions based on this finding

The Research Details

This was a cross-sectional study, which means researchers took a snapshot in time by measuring vitamin D levels in three groups of children at the same point. They measured two things: the amount of vitamin D in the blood using a lab test called ELISA, and the levels of a protein called the vitamin D receptor that helps cells use vitamin D. The children were divided into three groups: those with standard-risk ALL (less aggressive cancer), those with high-risk ALL (more aggressive cancer), and healthy children as a comparison group. All children were treated at one hospital in Indonesia.

Understanding whether children with ALL have different vitamin D levels is important because vitamin D helps control our immune system and may affect how cancer cells grow. If vitamin D deficiency is common in ALL, it could be something doctors routinely check and treat. This type of snapshot study is useful for identifying patterns that researchers can then study more deeply with experiments.

This study has several strengths: it used a standardized lab test (ELISA) to measure vitamin D accurately, it included a healthy control group for comparison, and it had a reasonable sample size of 90 children. However, because it’s a cross-sectional study, it only shows a picture at one moment in time and cannot prove that low vitamin D causes ALL or that fixing vitamin D levels will help treat it. The study was conducted at one hospital in one country, so results may not apply everywhere. The researchers used proper statistical methods to analyze their data.

What the Results Show

The most striking finding was that vitamin D deficiency was extremely common in children with ALL. About 82% of all children with ALL had vitamin D levels below 20 ng/mL (the cutoff for deficiency). When comparing the groups, children with ALL had significantly lower vitamin D levels than healthy children. Children with standard-risk ALL had a median level of 13.29 ng/mL, those with high-risk ALL had 13.94 ng/mL, and healthy children had 19.61 ng/mL. The difference between the ALL groups and the healthy group was very statistically significant (P<0.001), meaning there’s less than a 1 in 1,000 chance this happened randomly. Interestingly, there was no major difference in vitamin D levels between the standard-risk and high-risk ALL groups, suggesting vitamin D deficiency affects both types similarly.

The study also measured vitamin D receptor (VDR) concentrations, a protein that helps cells use vitamin D. The standard-risk group had the highest median VDR level at 0.600 ng/mL, but the differences between groups were not statistically significant (P=0.163). However, the researchers found a positive correlation between vitamin D levels and VDR concentrations (P=0.001), meaning children with higher vitamin D tended to have higher VDR levels. This suggests these two measurements are connected, though the relationship is moderate in strength.

This study adds to growing evidence that vitamin D deficiency may be common in children with cancer. Previous research has suggested that vitamin D plays important roles in immune function and controlling cell growth, both relevant to cancer. However, most previous studies on vitamin D and leukemia have been in adults or have looked at different aspects of the disease. This study is one of the first to specifically examine vitamin D levels and VDR concentrations together in children with ALL in an Asian population, making it a valuable addition to the research.

This study has important limitations to consider. First, it’s a snapshot study that shows association but not causation—we can’t conclude that low vitamin D causes ALL or that raising vitamin D will treat it. Second, the study was done at one hospital in Indonesia, so results may not apply to children in other countries with different genetics, diets, or sun exposure. Third, the study didn’t measure other factors that affect vitamin D levels, like sun exposure, diet, or skin tone. Fourth, the sample size of 90 is relatively small for drawing broad conclusions. Finally, the study didn’t follow children over time to see if vitamin D levels changed or affected their treatment outcomes.

The Bottom Line

Based on this research, doctors caring for children with ALL may want to: (1) Screen for vitamin D deficiency as part of routine care, (2) Consider vitamin D supplementation if deficiency is found, and (3) Monitor vitamin D levels during treatment. However, these are supportive measures—vitamin D supplements should not replace standard cancer treatments. The confidence level for these recommendations is moderate because this is one study and more research is needed.

This research is most relevant to: children newly diagnosed with ALL and their families, pediatric oncologists and hematologists treating ALL, and healthcare providers in countries where vitamin D deficiency is common. Parents of children with ALL should discuss vitamin D screening with their child’s cancer doctor. This research is NOT a reason to give vitamin D supplements to healthy children as cancer prevention—that’s not what the study shows. People without ALL should not assume they need vitamin D supplementation based on this study alone.

If a child with ALL is found to have vitamin D deficiency and starts supplementation, it typically takes 2-3 months to see vitamin D levels normalize with consistent supplementation. However, this study doesn’t provide information about how long it takes to see any potential benefits for cancer treatment or immune function. Any changes to treatment should be discussed with the child’s oncology team.

Want to Apply This Research?

  • For children with ALL receiving vitamin D supplementation, track weekly vitamin D supplement doses taken (yes/no) and any side effects or symptoms. Record the date and result of vitamin D blood tests when available to monitor levels over time.
  • If your child has been prescribed vitamin D supplements, set up a daily reminder in the app to take the supplement at the same time each day (such as with breakfast). Use the app to log when supplements are taken and note any barriers to taking them consistently.
  • Create a long-term tracking system that records: (1) vitamin D supplement doses taken weekly, (2) dates of vitamin D blood tests and results, (3) any symptoms or side effects, and (4) overall energy levels or wellness. Share this data with your child’s oncology team at each visit to ensure coordinated care.

This research describes an association between vitamin D deficiency and acute lymphoblastic leukemia in children but does not prove that low vitamin D causes leukemia or that vitamin D supplements can treat it. Vitamin D supplementation should never replace standard medical treatment for leukemia. Parents and caregivers of children with ALL should discuss vitamin D screening and supplementation only with their child’s oncology team, as vitamin D can interact with some cancer medications and treatments. This information is for educational purposes only and should not be used to make medical decisions without consulting qualified healthcare providers.