{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T03:53:17Z","timestamp":1791604397420,"version":"4.3.4"},"reference-count":11,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2026,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Patients with early\u2010stage chronic lymphocytic leukemia (CLL) are typically managed with a watch\u2010and\u2010wait strategy, and no intervention has been shown to modify the natural history of the disease.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We analyzed a large real\u2010world cohort derived from Clalit Health Services, including patients diagnosed with early\u2010stage CLL between 2000 and 2022 who were initially managed with active surveillance. Exposure was defined as vitamin D supplementation for at least 6 months during the watch\u2010and\u2010wait period. The primary endpoint was treatment\u2010free survival (TFS). Multivariable time\u2010dependent Cox models and inverse probability of treatment weighting were applied to adjust for baseline differences.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The cohort included 5496 patients, of whom 1862 (34%) received vitamin D supplementation. Median age at diagnosis was 72.2 years, and 56% were male. Median follow\u2010up was 46 months. Patients receiving vitamin D demonstrated significantly longer TFS compared with nonusers (median 147 vs. 82 months,\n p<\/jats:italic>\n <0.001). In multivariable time\u2010dependent Cox analysis adjusted for age, sex, and laboratory parameters, vitamin D exposure remained independently associated with improved TFS (HR: 0.87, 95% CI: 0.75\u20130.99;\n p<\/jats:italic>\n = 0.027).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In this large real\u2010world validation cohort, vitamin D supplementation was associated with prolonged TFS in patients with early\u2010stage CLL managed with active surveillance.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n The authors have confirmed clinical trial registration is not needed for this submission.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jha2.70336","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T12:34:02Z","timestamp":1782995642000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vitamin D Supplementation and Treatment\u2010Free Survival in Early\u2010Stage CLL: A Real\u2010World Validation Study"],"prefix":"10.1002","volume":"7","author":[{"given":"Tamar","family":"Tadmor","sequence":"first","affiliation":[{"name":"Hematology Unit Bnai Zion Medical Center and the Ruth and Bruce Rappaport Faculty of Medicine Technion Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronen","family":"Arbel","sequence":"additional","affiliation":[{"name":"Community Medical Services Division Clalit Health Services Tel Aviv Israel"},{"name":"Maximizing Health Outcomes Lab Sapir College Sderot Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talish","family":"Razi","sequence":"additional","affiliation":[{"name":"Community Medical Services Division Clalit Health Services Tel Aviv Israel"},{"name":"Maximizing Health Outcomes Lab Sapir College Sderot Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lior","family":"Rokach","sequence":"additional","affiliation":[{"name":"Department of Software and Information Systems Engineering Ben\u2010Gurion University of the Negev Beer\u2010Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102017\u201009\u2010806398"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13020285"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2016.378"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102002\u201007\u20101984"},{"key":"e_1_2_8_6_1","first-page":"129","article-title":"Chronic Lymphocytic Leukaemia Responsive to Vitamin D Administration","volume":"156","author":"Arlet J.\u2010B.","year":"2011","journal-title":"British Journal of Haematology"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2023011458"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2011.10.004"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.57.5092"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/bcj.2017.9"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2024013428"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102959"}],"container-title":["eJHaem"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jha2.70336","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jha2.70336","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jha2.70336","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T03:42:40Z","timestamp":1791603760000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jha2.70336"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/jha2.70336"],"URL":"https:\/\/doi.org\/10.1002\/jha2.70336","archive":["Portico"],"relation":{},"ISSN":["2688-6146","2688-6146"],"issn-type":[{"value":"2688-6146","type":"print"},{"value":"2688-6146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]},"assertion":[{"value":"2026-05-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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