Does Level of Vitamin D Prior to Allogeneic Stem Cell Transplantation Affect the Transplant Outcomes?

Abstract

Introduction Vitamin D, a fat soluble vitamin which is the main regulator of calcium homeostasis and metabolism affects the immune system functions by modulating the differentiation and activation of T and B lymphocytes. It has been demonstrated that low level of vitamin D level in patients undergoing allogeneic stem cell transplantation is a risk factor for devolopment of chronic graft versus host disease (GVHD). It has been also reported that vitamin D defficiency is associated with CMV reactivation. Patients and Methods One hundred patients undergoing allogenic stem cell transplantation in our center were included in the study. Serum vitamin D level was measured prior to transplantation. Ninety-seven of 100 patients had low level of vitamin D. Mean level of vitamin D was 9.95 ng/ml (ranges 3.10 – 36.5). Patients were seperated two groups in terms of vitamin D level. Patients who had very low level of vitamin D ( 10 ng/ml. Results There were no differences in patient, disease and transplant characteristics between two groups. Incidence of grade 2-4 acute GVHD (14/43 vs 12/46), chronic GVHD (15/42 vs 12/38), CMV reactivation (18/50 vs 20/50), hemorrhagic cystitis (8/50 vs 9/50), BK visrus associated hemorrhagic cystitis (6/50 vs 4/50) were not statistically different in patient with severe vitamin D defficiency compared with patients who had vitamin D level of >10 ng/ml. There were no significant difference between two groups in terms of 1 and 2-year PFS (%69 vs %68 and %65 vs %60) and OS ((%73 vs %73 and %67 vs %60). Conclusions Suboptimal vitamin D levels are common in adult patients undergoing allogenic stem cell transplantation. Unlike other studies, we did not observed any important impact of vitamin D level on outcome of transplantation in adult patients. Further studies with larger population are necesssary to delineate the role of vitamin D in patients undergoing allogenic stem cell transplantation.