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Graft-Versus-Host Disease

Low levels of 25-hydroxyvitamin D before allogeneic hematopoietic SCT correlate with the development of chronic GVHD

Bone Marrow Transplantation volume 48, pages 593–597 (2013)Cite this article

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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.

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Acknowledgements

This work was supported in part by the Pasquarello Tissue Bank and NIH grants CA142106 and AI29530.

Author contributions: B Glotzbecker was involved in research design, data analysis and manuscript preparation. VT Ho provided clinical data from the DFCI data repository and assisted with design research. J Aldridge and H Kim performed statistical analysis. G Horowitz performed measurement of vitamin D levels. J Ritz was involved in research design and contributed patient samples. R Soiffer and D Avigan were involved in research design and manuscript preparation. J Rosenblatt was involved in research design, data analysis and manuscript preparation.

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Authors and Affiliations

  1. Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA

    B Glotzbecker, V T Ho, J Aldridge, H T Kim, J Ritz & R Soiffer

  2. Department of Clinical Chemistry, Beth Israel Deaconess Medical Center, Boston, MA, USA

    G Horowitz

  3. Department of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    D Avigan & J Rosenblatt

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Glotzbecker, B., Ho, V., Aldridge, J. et al. Low levels of 25-hydroxyvitamin D before allogeneic hematopoietic SCT correlate with the development of chronic GVHD. Bone Marrow Transplant 48, 593–597 (2013). https://doi.org/10.1038/bmt.2012.177

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