Vitamin K deficiency in children pre-bone marrow transplantation

Area of Science:

• Pediatric Hematology
• Nutritional Biochemistry

Background:

• Vitamin K is crucial for coagulation and bone metabolism.
• Children undergoing bone marrow transplantation (BMT) may be at risk for nutritional deficiencies.
• Assessing vitamin K status is important in this vulnerable population.

Purpose of the Study:

• To determine the prevalence of vitamin K deficiency in children prior to BMT.
• To evaluate the effectiveness of PIVKA-II assay and prothrombin times in assessing vitamin K status.
• To identify risk factors associated with vitamin K deficiency in this cohort.

Main Methods:

• Prospective study involving pediatric patients scheduled for BMT.
• Vitamin K status assessed using PIVKA-II assay and prothrombin times.
• Blood samples collected before the initiation of vitamin-containing total parenteral nutrition (TPN).

Main Results:

• 31% (8 of 26) of patients exhibited vitamin K deficiency.
• Deficiency causes included drug antagonism (phenytoin) and inadequate intake, synthesis, or malabsorption.
• Only one patient had a prolonged prothrombin time, indicating its ineffectiveness as a screening tool.
• Patients on phenytoin and chemotherapy are at higher risk.

Conclusions:

• Vitamin K deficiency is prevalent in children awaiting BMT.
• PIVKA-II assay is a more sensitive measure of vitamin K status than prothrombin time in this population.
• Prophylactic vitamin K supplementation and monitoring are recommended for children receiving phenytoin and chemotherapy prior to BMT.