title: Low levels of 25-hydroxyvitamin D before allogeneic hematopoietic SCT correlate with the development of chronic GVHD.
abstract: Vitamin D, a hormone involved in bone and calcium homeostasis, has been shown to have potent immunomodulatory effects. We performed a retrospective cohort analysis to evaluate whether monohydroxyvitamin D levels before allogeneic hematopoietic SCT (HSCT) correlate with the risk of GVHD. Fifty-three patients who underwent myeloablative HSCT were studied. Vitamin D levels were measured in serum samples obtained before HSCT. The median 25-hydroxyvitamin vitamin D level was 21.9 ng/mL (7.8-45.7). The cumulative incidence (CI) of grades II-IV acute GVHD at 100 days was 53.1% in patients with vitamin D<25, versus 33.3% in patients with vitamin D ≥ 25 ng/mL (P=0.13). The CI of chronic GVHD (cGVHD) at 2 years in patients with vitamin D<25 was 63.8%, compared with 23.8% in patients with vitamin D ≥ 25 ng/mL (P=0.009). Similarly, the 2 year CI of extensive cGVHD was significantly greater in patients with vitamin D<25 compared with those with vitamin D ≥ 25 ng/mL (54.5% versus 14.3%, P=0.005). In a multivariable competing risk model, low pre-transplant vitamin D levels remained a significant factor associated with cGVHD (hazard ratio=5.26, P=0.02). Our results demonstrate that vitamin D deficiency before HSCT is associated with an increased risk of cGVHD.
authors.affiliation: Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02115, USA. brett_glotzbecker@dfci.harvard.edu
authors.forename: B
authors.initials: B
authors.lastname: Glotzbecker
authors.forename: V T
authors.initials: VT
authors.lastname: Ho
authors.forename: J
authors.initials: J
authors.lastname: Aldridge
authors.forename: H T
authors.initials: HT
authors.lastname: Kim
authors.forename: G
authors.initials: G
authors.lastname: Horowitz
authors.forename: J
authors.initials: J
authors.lastname: Ritz
authors.forename: R
authors.initials: R
authors.lastname: Soiffer
authors.forename: D
authors.initials: D
authors.lastname: Avigan
authors.forename: J
authors.initials: J
authors.lastname: Rosenblatt
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D013997:Time Factors; D014184:Transplantation, Homologous; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D