Vitamin D levels and their associations with survival and major disease outcomes in a large cohort of patients with chronic graft-vs-host disease

Katić, Mašenjka; Pirsl, Filip; Steinberg, Seth M.; Dobbin, Marnie; Curtis, Lauren M.; Pulanić, Dražen; Desnica, Lana; Titarenko, I V; Pavletić, Steven Z.

doi:10.3325/cmj.2016.57.276

Cited by 9 publications

(11 citation statements)

References 34 publications

(42 reference statements)

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“…However, the primary endpoint of our analysis was TRM, not overall mortality. Conflicting data have also been published looking at 25-hydroxyvitamin-D3 and association with aGvHD [ 5 , 23 , 26 ] and cGvHD [ 4 , 5 , 7 , 26 – 28 ]. When we tested for an association of severe aGvHD or cGvHD with 1,25(OH)2D3 levels, respectively, no significant association was detected.…”

Section: Discussionmentioning

confidence: 99%

1,25-dihydroxyvitamin-D3 but not the clinically applied marker 25-hydroxyvitamin-D3 predicts survival after stem cell transplantation

Peter

Siska

Roider

et al. 2020

Bone Marrow Transplant

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The serum level of 25-hydroxyvitamin-D3 is accepted as marker for a person’s vitamin D status but its role for the outcome of allogeneic hematopoietic stem cell transplantation (HSCT) is controversially discussed. The impact of 1,25-dihydroxyvitamin-D3 on HSCT outcome, however, has never been studied. In a discovery cohort of 143 HSCT patients we repeatedly (day −16 to 100) measured 1,25-dihydroxyvitamin-D3 and in comparison the well-established marker for serum vitamin D status 25-hydroxyvitamin-D3. Only lower 1,25-dihydroxyvitamin-D3 levels around HSCT (day −2 to 7, peritransplant) were significantly associated with higher 1-year treatment-related mortality (TRM) risk (Mann–Whitney U test, P = 0.001). This was confirmed by Cox-model regression without and with adjustment for baseline risk factors and severe acute Graft-versus-Host disease (aGvHD; unadjusted P = 0.001, adjusted P = 0.005). The optimal threshold for 1,25-dihydroxyvitamin-D3 to identify patients at high risk was 139.5 pM. Also in three replication cohorts consisting of altogether 365 patients 1,25-dihydroxyvitamin-D3 levels below 139.5 pM had a 3.3-fold increased risk of TRM independent of severe aGvHD compared to patients above 139.5 pM (Cox-model unadjusted P < 0.0005, adjusted P = 0.001). Our data highlight peritransplant 1,25-dihydroxyvitamin-D3 levels but not the commonly monitored 25-hydroxyvitamin-D3 levels as potent predictor of 1-year TRM and suggest to monitor both vitamin D metabolites in HSCT patients.

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Section: Discussionmentioning

confidence: 99%

1,25-dihydroxyvitamin-D3 but not the clinically applied marker 25-hydroxyvitamin-D3 predicts survival after stem cell transplantation

Peter

Siska

Roider

et al. 2020

Bone Marrow Transplant

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“…Some of them [166,168,169] specifically described an impact of vitamin D deficiency on chronic GvHD incidences. By contrast, other studies did not find a significant correlation [162,[170][171][172][173][174][175][176][177][178].…”

Section: Vitamin D Levels: Impacts On Allogenic Hsct Outcomesmentioning

confidence: 61%

Effect of Vitamin D on Graft-versus-Host Disease

et al. 2022

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The different cell subsets of the immune system express the vitamin D receptor (VDR). Through the VDR, vitamin D exerts different functions that influence immune responses, as previously shown in different preclinical models. Based on this background, retrospective studies explored the impacts of vitamin D levels on the outcomes of patients undergoing allogeneic hematopoietic stem-cell transplantation, showing that vitamin D deficiency is related to an increased risk of complications, especially graft-versus-host disease. These results were confirmed in a prospective cohort trial, although further studies are required to confirm this data. In addition, the role of vitamin D on the treatment of hematologic malignancies was also explored. Considering this dual effect on both the immune systems and tumor cells of patients with hematologic malignancies, vitamin D might be useful in this setting to decrease both graft-versus-host disease and relapse rates.

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“…To the best of our knowledge, this study constitutes the first investigation of the 25(OH)D levels specifically in preschool children in Croatia and the surrounding countries (the territory of the former Yugoslavia). Additionally, studies performed on other samples in Croatia (i.e., adults and adolescents) mostly focused on specific populations with severe health conditions, which makes comparison of the results additionally difficult [ 50 , 51 ]. Therefore, we could not specifically compare our results with those previously reported for children, and future studies are needed to confirm our results.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Status and Analysis of Specific Correlates in Preschool Children: A Cross-Sectional Study in Southern Croatia

Karin

Gilić

Domić

et al. 2018

IJERPH

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Vitamin D deficiency is a globally important problem, particularly in children, but there is a lack of information regarding this deficiency in preschool children from southeastern Europe. This study aimed to establish the levels of 25-hydroxyvitamin D (25(OH)D) and associations of gender, time spent outdoors, physical activity (PA), and body mass index (as predictors) with the 25(OH)D level (outcome) in healthy preschool children. The participants were preschoolers (all 5–6 years of age) from southern Croatia. All the participants were tested during their mandatory medical examination 6–7 months prior to school enrollment. The PA was obtained using the preschool-age physical activity questionnaire (Pre-PAQ), which categorizes PA into five levels (from sedentary to vigorous PA). The prevalence of 25(OH)D deficiency was high: 58% of the children had 25(OH)D levels of <50 nmol/L (deficiency), and an additional 29% had an insufficient level of 25(OH)D (50–75 nmol/L). Boys had higher levels of 25(OH)D than girls. A multinomial regression using 25(OH)D categories as the outcome and a sufficient level (>75 nmol/L) as the reference value identified gender as the only significant predictor of 25(OH)D status, with boys being at lower risk for 25(OH)D deficiency than girls. These results showed a high prevalence of 25(OH)D deficiency in preschoolers from the southern part of Croatia, which is additionally alarming based on the geographical position of the studied region (42° N) and its high number of sunshine hours (>2600 h per year). Future studies examining other potential correlates of 25(OH)D in the region are warranted.

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Vitamin D levels and their associations with survival and major disease outcomes in a large cohort of patients with chronic graft-vs-host disease

Cited by 9 publications

References 34 publications

1,25-dihydroxyvitamin-D3 but not the clinically applied marker 25-hydroxyvitamin-D3 predicts survival after stem cell transplantation

1,25-dihydroxyvitamin-D3 but not the clinically applied marker 25-hydroxyvitamin-D3 predicts survival after stem cell transplantation

Effect of Vitamin D on Graft-versus-Host Disease

Vitamin D Status and Analysis of Specific Correlates in Preschool Children: A Cross-Sectional Study in Southern Croatia

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