Vitamin D level after allogeneic hematopoietic stem cell transplant

Area of Science:

• Hematology
• Endocrinology
• Oncology

Background:

• Vitamin D (VD) deficiency is linked to bone diseases like osteomalacia, osteopenia, and osteoporosis, causing pain, weakness, and fracture risk.
• Patients undergoing treatment for acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) may have reduced sunlight exposure and gastrointestinal issues, impacting VD levels.
• Allogeneic hematopoietic cell transplant (HCT) survivors are at risk for VD deficiency and subsequent bone density loss.

Purpose of the Study:

• To investigate the incidence of low Vitamin D (VD) levels and low bone mineral density in patients with AML or ALL following allogeneic HCT.
• To identify factors associated with VD deficiency and abnormal bone density in this patient population.

Main Methods:

• Retrospective analysis of 289 patients with AML or ALL who underwent HCT between January 2000 and January 2009.
• Assessment of VD levels and bone mineral density (BMD) in a subset of patients post-HCT.
• Evaluation of patient data for graft-versus-host disease (GVHD), corticosteroid use, VD supplementation, and parathyroid hormone (PTH) levels.

Main Results:

• Of 58 patients tested, 89.7% had low VD levels post-HCT.
• Among 49 patients with BMD testing, 65% exhibited abnormal (low) bone density.
• Low VD levels were frequently associated with corticosteroid use (98.3%), GVHD (94.8%), and elevated PTH (65%).

Conclusions:

• A high prevalence of Vitamin D deficiency and low bone mineral density exists in AML/ALL patients after HCT.
• VD deficiency is associated with factors common in HCT recipients, including GVHD and corticosteroid treatment.
• Routine VD level monitoring and supplementation should be considered for HCT survivors to mitigate bone-related morbidity.