Impact of a Vitamin D Replacement Algorithm in Children and Young Adults With Acute Lymphoblastic Leukemia

Area of Science:

• Pediatric Oncology
• Endocrinology
• Nutritional Science

Background:

• Pediatric cancer patients, particularly those with acute lymphoblastic leukemia (ALL), exhibit a high prevalence of vitamin D deficiency.
• Chemotherapy and supportive care in pediatric ALL contribute to poor bone health outcomes.
• A lack of evidence-based vitamin D guidelines exists for this specific patient group.

Purpose of the Study:

• To evaluate the effectiveness of an institutional guideline for standardized vitamin D monitoring and supplementation in pediatric and young adult ALL patients.
• To determine the impact of the guideline on achieving and maintaining adequate 25-hydroxyvitamin D levels (≥30 ng/mL).

Main Methods:

• Retrospective study analyzing data from 69 pediatric and young adult ALL patients over 22 months.
• Standardized monitoring of 25-hydroxyvitamin D levels every 3 months.
• Supplementation based on patient age and 25-hydroxyvitamin D levels, aiming for ≥30 ng/mL.

Main Results:

• At diagnosis, 60.8% of patients were vitamin D insufficient.
• Following supplementation, 83.3% of initially insufficient patients achieved sufficient levels at the first repeat check.
• Overall vitamin D sufficiency reached 95.6% by the study's completion, overcoming baseline seasonal variations.

Conclusions:

• The implemented vitamin D replacement guidelines were highly effective in rapidly increasing vitamin D sufficiency in pediatric and young adult ALL patients.
• Standardized monitoring and supplementation protocols can successfully address vitamin D deficiency in this high-risk population.