The Relationship Between Pre-Transplant 25-Hydroxy-Vitamin D Levels, Survival and Graft-Versus-Host Disease, in Allogeneic Haematopoietic Stem Cell Transplantation

Perera, Travis; Lim, Andrew; Mason, Kate; Szer, Jeffrey; Ritchie, David

doi:10.1016/j.bbmt.2014.11.482

Cited by 7 publications

(10 citation statements)

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“…The high incidence of vitamin D deficiency in allogeneic HSCT patients, alongside the current controversy (9,11,84,114,115,132,141), emphasizes the need for further studies on the impact of vitamin D deficiency and VDR gene polymorphisms on clinical outcomes to define its role as a biomarker in this setting.…”

Section: Discussionmentioning

confidence: 99%

“…Supporting this, another clinical study showed that cGvHD developed in patients with lower 25(OH)D 3 serum levels at transplantation (9). In contrast, other clinical studies failed to find any correlation between vitamin D serostatus and cGvHD (10,115,132).…”

Section: Graft-versus-host Diseasementioning

confidence: 91%

“…Vitamin D deficiency can contribute to the imbalance of immune homeostasis, shifting from a tolerogenic to a pro-inflammatory status (89, 113). In the allogeneic HSCT, this can have an impact on complications post-transplantation, and potentially on survival outcomes (9,11,114,115).…”

Section: Impact Of Vitamin D In Hsctmentioning

confidence: 99%

“…Three clinical studies have linked 1,25(OH) 2 D 3 serostatus and acute GvHD (aGvHD): Urbain et al demonstrated that patients with moderate to severe aGvHD had lower levels of 25(OH)D 3 (132). Nevertheless, these results could not be reproduced in other studies (10,69,84,115). Glotzbecker et al reported that patients with lower levels of 25(OH)D 3 prior to HSCT had a higher cumulative incidence of Chronic GvHD (cGvHD) and extensive cGvHD compared to those with higher levels (84).…”

Section: Graft-versus-host Diseasementioning

confidence: 99%

“…Outcomes Post-HSCT (Table 1) As previously described, vitamin D has an immune-modulatory role, and it may protect against infections and blunt tissue damage on the course of HSCT (54,91). Owing to this, recent studies have tried to elucidate its role in outcomes following allogeneic HSCT, with conflicting results: A prospective study performed in pediatric patients revealed that vitamin D deficiency post-HSCT was associated with a lower overall survival (OS) (114), as seen in other studies evaluating OS at different time points (9,11,115). Nevertheless, further research could not prove the link between vitamin D serostatus and progression-free survival (84, 115), 2-years disease-free survival (9), or OS (84, 132, 141), thus no definitive conclusions can be drawn from them.…”

Section: Resistance To Steroids In Gvhdmentioning

confidence: 99%

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Insights Into the Role of Vitamin D as a Biomarker in Stem Cell Transplantation

et al. 2020

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Vitamin D was discovered 100 years ago and since then multiple studies have consistently proved its effect on bone health and mineral metabolism. Further research has also explored its so-called "non-classical" biological effects, encompassing immune regulation and control of cell proliferation and differentiation. Vitamin D downregulates pro-inflammatory immune cells and subsequently their cytokine production, while enhancing the anti-inflammatory subsets, thus mediating inflammation and fostering a more tolerogenic environment. Its biological action is exerted through the vitamin D receptor, a nuclear receptor that mediates gene transcription and is expressed in most cells from the innate and adaptive immunity. Owing to its immune-modulatory properties, its role in cancer pathophysiology, hematology disorders and stem cell transplantation has also been investigated. Vitamin D deficiency causes immune imbalance and cytokine dysregulation, contributing to some autoimmune diseases. In the hematopoietic stem cell transplant setting this could lead to complications such as acute and chronic graft-versus-host disease, ultimately impacting transplant outcomes. Other factors have also been linked to this, including specific polymorphisms of the vitamin D receptor in both stem cell donors and recipients. Nevertheless, studies thus far have shown conflicting results and the use of vitamin D or its receptor as biomarkers has not been validated yet, therefore there are no evidence-based consensus guidelines to guide clinicians in their day-today practice. To gain more insight in this topic, we have reviewed the existent literature and gathered the current evidence. This is an overview of the role of serum vitamin D and its receptor as biomarkers for clinical outcomes in patients undergoing hematopoietic stem cell transplantation. Further prospective studies with larger cohorts are warranted to validate the viability of using serum vitamin D, and its receptor, as biomarkers in potential stem cell donors and patients, to identify those at risk of post-transplant complications and enable early therapeutic interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Graft-versus-host Diseasementioning

confidence: 91%

Section: Impact Of Vitamin D In Hsctmentioning

confidence: 99%

Section: Graft-versus-host Diseasementioning

confidence: 99%

Section: Resistance To Steroids In Gvhdmentioning

confidence: 99%

See 3 more Smart Citations

Insights Into the Role of Vitamin D as a Biomarker in Stem Cell Transplantation

et al. 2020

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Vitamin D deficiency and graft-versus-host disease in hematopoietic stem cell transplant population

Arain

Matthiesen

2019

Hematology/Oncology and Stem Cell Therapy

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Vitamins are the organic compounds that have long been known to play a significant role in our body by functioning as hormones and antioxidants. Vitamin D, a fat-soluble vitamin, is the main regulator of calcium hemostasis in our body. At the same time, it is also known to show its potential effects on the immune system by modulating the differentiation, activation, and proliferation of T and B lymphocytes. The immunomodulatory properties of vitamin D are also known to have a crucial role in the prevention and treatment of graft-versus-host disease. Patients undergoing hematopoietic stem cell transplantation are particularly at risk of vitamin D deficiency. This review article expands our understanding of vitamin D, its immunomodulatory effects, and its role in prevention and treatment of graft-versus-host disease.

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