Vitamin D deficiency in children and adolescents submitted to hematopoietic stem cell transplantation.
BACKGROUND
Sub-optimal levels of vitamin D have been found to be highly prevalent in all age groups, with epidemiologic studies demonstrating a link between vitamin D deficiency and disease susceptibility, such as infection and cancer, and mortality rates. In adult transplant patients, it has been suggested that the immunomodulatory properties of vitamin D may have an important role in the prevention and treatment of graft-versus-host disease.


OBJECTIVE
The objective of this study was to assess serum 25-hydroxyvitamin D levels of children and adolescents submitted to allogeneic hematopoietic stem cell transplantation.


METHODS
Serum 25-hydroxyvitamin D levels of 66 patients, aged 4-20 years, were assessed at three stages: before hospitalization for hematopoietic stem cell transplantation and at 30 and 180 days after hematopoietic stem cell transplantation. The control group consisted of 25 healthy children.


RESULTS
At the pre-hematopoietic stem cell transplantation stage, patients had lower levels of 25-hydroxyvitamin D compared to controls (25.7 ± 12.3 ng/mL vs. 31.9 ± 9.9 ng/mL; p-value = 0.01), and a higher prevalence of 25-hydroxyvitamin D deficiency (32% vs. 8%; p-value = 0.01). Prevalence increased significantly after hematopoietic stem cell transplantation (p-value = 0.01) with half of the patients having vitamin D deficiency at 180 days after transplantation. At this stage, mean serum 25-hydroxyvitamin D levels were 20.9 ± 10.9 ng/mL, a significant decline in relation to baseline (p-value = 0.01). No correlation was found between 25-hydroxyvitamin D levels and vitamin D intake, graft-versus-host disease, corticoid use or survival rates.


CONCLUSIONS
Low levels of 25-hydroxyvitamin D were detected even before hematopoietic stem cell transplantation and were significantly lower at 180 days after hematopoietic stem cell transplantation, thus recommending vitamin D supplementation for children and adolescents submitted to hematopoietic stem cell transplantation.
Universidade Federal do Paraná, Curitiba, PR, Brazil, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
Denise Johnsson
DJ
Campos
Universidade Federal do Paraná, Curitiba, PR, Brazil, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
Gleyne Lopes Kujew
GL
Biagini
Universidade Federal do Paraná, Curitiba, PR, Brazil, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
Vaneuza Araujo Moreira
VA
Funke
Universidade Federal do Paraná, Curitiba, PR, Brazil, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
Carmem Maria Sales
CM
Bonfim
Universidade Federal do Paraná, Curitiba, PR, Brazil, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
César Luiz
CL
Boguszewski
Universidade Federal do Paraná, Curitiba, PR, Brazil, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
Victória Zeghbi Cochenski
VZ
Borba
Bone marrow transplantation; Child nutrition; Hematopoietic stem cell transplantation; Vitamin D; Vitamin D deficiency