Background
Pediatric patients undergoing hematopoietic stem cell transplantation (HSCT) are frequently diagnosed with vitamin D deficiency, which may impact outcomes.
Objectives
: To estimate the prevalence of vitamin D deficiency and examine its association with short‐term survival in pediatric HSCT patients.
Methods
Patients undergoing HSCT at Phoenix Children's Hospital were retrospectively identified. Routine serum 25‐hydroxyvitamin D measurements were described prior to transplant and at 100 days and 1‐year post‐HSCT. Associations of pre‐HSCT vitamin D groups (i.e., normal ≥30 ng/ml, insufficient 20–29 ng/ml, and deficient <30 ng/ml) with demographics, clinical factors, and outcomes were examined using nonparametric tests and Cox proportional hazards analyses.
Results
: Among 72 study subjects, the median vitamin D pre‐HSCT was 26 ng/ml (range: 19–34 ng/ml). Levels were insufficient and deficient in 25 (35%) and 20 (28%) patients, respectively, with only two (3%) patients on supplemental therapy pre‐HSCT. Despite supplemental therapy provided to 46 (74%) subjects, insufficient/deficient rates did not significantly change between pre‐HSCT and 100 days post‐HSCT, but mean vitamin D levels significantly increased by 1‐year post‐HSCT (P = 0.01).Vitamin D pre‐HSCT was not associated with the development of acute or chronic graft‐versus‐host disease (GVHD) or delayed engraftment. Overall 1‐year survival was significantly lower for patients with deficient (65%) compared to normal (93%) pre‐HSCT vitamin D (P = 0.001).
Conclusion
Suboptimal vitamin D levels are common in pediatric patients scheduled to receive HSCT and are associated with lower overall 1‐year survival. Further study is warranted to delineate the mechanisms underlying the role of vitamin D in successful HSCT.