Vitamin D status among long-term survivors of hematopoietic cell transplantation

• Published in: Bone marrow transplantation (Basingstoke) Vol. 46; no. 11; pp. 1472 - 1479
• Main Authors: Robien, K, Strayer, L G, Majhail, N, Lazovich, D, Baker, K S, Smith, A R, Mulrooney, D A, Burns, L J
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.11.2011; Nature Publishing Group
• Subjects: 25-Hydroxyvitamin D; 631/443/810; 692/308/2778; 692/700/459/1994; 692/700/565/545/576/1955; Absorptivity; Adolescent; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Body Mass Index; Bone marrow; Bone Marrow Transplantation - adverse effects; Bone marrow, stem cells transplantation. Graft versus host reaction; Calciferol; Cancer survivors; Cell Biology; Child; Child, Preschool; Demographic aspects; Dietary Supplements; Distribution; Female; Graft-versus-host reaction; Health risks; Hematology; Hematopoietic stem cells; Humans; Internal Medicine; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; original-article; Physiological aspects; Pilot Projects; Prednisone; Prednisone - adverse effects; Public Health; Stem cell transplantation; Stem Cells; Sunlight; Survivors; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Vitamin D; Vitamin D - administration & dosage; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D deficiency; Vitamin D Deficiency - blood; Vitamin D Deficiency - etiology; Minnesota; dietary supplements; diet; hematopoietic cell transplantation; serum 25(OH)D; cancer survivors; vitamin D; Hematology; Nutrition; Steroid hormone; Survivor; Stem cell; Hematopoietic cell; Malignant tumor; Long term; Feeding; Diet; Vitamin D; Cholecalciferol(25-hydroxy); Graft; Serum; Supplementation; Cancer
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2010.326

Little is known about serum vitamin D levels following hematopoietic cell transplantation (HCT). Patients are instructed to avoid sun exposure because of an increased risk of skin cancers. Altered gastrointestinal absorptive capacity as a result of GVHD, bile acid or pancreatic enzyme insufficiency or bacterial overgrowth may lead to difficulty in absorbing the fat-soluble vitamin D. This study was undertaken to determine the prevalence of serum 25-hydroxyvitamin D (25(OH)D) deficiency, and factors associated with 25(OH)D deficiency, among children and adults who were at least 1 year following HCT. A total of 95 participants (54 males and 41 females) completed a questionnaire on usual diet and lifestyle, and provided a blood sample for 25(OH)D determinations between November 2008 and July 2009. The majority of participants had serum 25(OH)D levels ⩾75 nmol/L ( n =62, 65%), 23 had insufficient levels (50–75 nmol/L) and 10 participants were deficient (<50 nmol/L). The majority of participants reported regular use of vitamin D supplements ( n =58, 61%). Prednisone use was significantly inversely associated with serum 25(OH)D concentrations. Total vitamin D intake was the strongest single predictor of 25(OH)D concentrations. These findings suggest that 400–600 IU vitamin D per day appears to be required to achieve optimal serum 25(OH)D concentrations following HCT.