The Association Between Serum Vitamin D Levels and Bone-Related Outcomes in Patients 100 Days Post-Bone Marrow Transplant

Abstract

Describe the effect of various risk factors on vitamin D status and BMD in patients who have received a bone marrow transplant. Bone marrow transplants (BMT) can have adverse outcomes, including low bone mineral density (BMD). However, little research has investigated the association of vitamin D status and bone-related outcomes in patients after BMT. Therefore, this study aims to describe the association between vitamin D status and bone-related outcomes in patients +100 days post-BMT, along with treatment practices that may affect vitamin D status. This retrospective chart review examined 149 BMT patient records and determined the relationship between serum 25(OH)D concentration and DXA T-scores using linear regression, correlation coefficients, and Chi-square tests. Chi-square tests were used to determine the association of vitamin D status and various categorical risk factors. The mean 25(OH)D concentration for the study population was 36.46 ng/mL. Over 60% of subjects had DXA T-scores that corresponded to a normal BMD. There was no significant association between 25(OH)D concentration and DXA T-scores. Vitamin D status was significantly associated with age (p=0.01), diagnosis (p<0.01), transplant type (p<0.01), immunosuppressant use (p<0.01), vitamin D supplementation (p=0.01) and amount (p=0.04), calcium supplementation (p=0.02) and amount (p=0.05). Risk factors are present post-BMT that may affect vitamin D status. However, the role that vitamin D plays in maintaining adequate bone mineral density in this population is unclear. Cross-sectional studies with larger sample sizes, stratification by transplant type, and increased length of time post-BMT should be conducted to further assess this association.