Vitamin D level after allogeneic hematopoietic stem cell transplant

Lisa Sproat, Brian Bolwell, Lisa Rybicki, Robert Dean, Ronald Sobecks, Brad Pohlman, Steven Andresen, John Sweetenham, Edward Copelan, Matt Kalaycio

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Vitamin D (VD) deficiency can cause osteomalacia, bone pain, muscle weakness, fatigue, and increased risk of fracture, and may precipitate or exacerbate osteopenia and osteoporosis. Patients receiving treatment for acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) may have limited exposure to sunlight and often experience gastrointestinal side effects that may decrease their ability to maintain an adequate VD level. We hypothesized that patients with AML and ALL would have a low VD level after allogeneic hematopoietic cell transplant (HCT), and that these patients would have a high incidence of osteoporosis/osteopenia. We therefore studied the incidence of low VD level and low bone mineral density after HCT. Of 289 patients with AML or ALL undergoing HCT between January 1, 2000, and January 31, 2009, at the Cleveland Clinic, 58 (20.1%) patients had VD testing after HCT. Of these, 52 (89.7%) patients had a low VD level, and 6 (10.3%) had a normal level. Most patients with VD testing had graft-versus-host disease (GVHD) and were taking corticosteroids (94.8% and 98.3%, respectively). Of the 49 patients with VD testing who also had bone mineral density testing, 65% had abnormal (low bone density) results. Only 21% of patients with VD testing were taking VD supplements prior to testing, and 65% had an elevated parathyroid hormone level. We found that most patients did not have VD testing after HCT, but those that did were very likely to have a low level and have low bone mineral density. Those with a low VD level were likely to have received corticosteroids, have GVHD, and have an elevated parathyroid hormone (PTH) level. Given the potential morbidity of low VD level, VD deficiency should be considered after HCT. Prospective study of VD level and its impact on morbidity and mortality after HCT is warranted.

Original languageEnglish (US)
Pages (from-to)1079-1083
Number of pages5
JournalBiology of Blood and Marrow Transplantation
Volume17
Issue number7
DOIs
StatePublished - Jul 1 2011
Externally publishedYes

Fingerprint

Hematopoietic Stem Cells
Vitamin D
Transplants
Bone Density
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Acute Myeloid Leukemia
Vitamin D Deficiency
Metabolic Bone Diseases
Graft vs Host Disease
Parathyroid Hormone
Osteoporosis
Adrenal Cortex Hormones
Morbidity
Osteomalacia
Muscle Fatigue
Aptitude
Sunlight
Incidence
Muscle Weakness
Prospective Studies

Keywords

  • Acute leukemia
  • Osteopenia
  • Osteoporosis
  • Stem cell transplant
  • Vitamin D

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Sproat, L., Bolwell, B., Rybicki, L., Dean, R., Sobecks, R., Pohlman, B., ... Kalaycio, M. (2011). Vitamin D level after allogeneic hematopoietic stem cell transplant. Biology of Blood and Marrow Transplantation, 17(7), 1079-1083. https://doi.org/10.1016/j.bbmt.2010.12.704

Vitamin D level after allogeneic hematopoietic stem cell transplant. / Sproat, Lisa; Bolwell, Brian; Rybicki, Lisa; Dean, Robert; Sobecks, Ronald; Pohlman, Brad; Andresen, Steven; Sweetenham, John; Copelan, Edward; Kalaycio, Matt.

In: Biology of Blood and Marrow Transplantation, Vol. 17, No. 7, 01.07.2011, p. 1079-1083.

Research output: Contribution to journalArticle

Sproat, L, Bolwell, B, Rybicki, L, Dean, R, Sobecks, R, Pohlman, B, Andresen, S, Sweetenham, J, Copelan, E & Kalaycio, M 2011, 'Vitamin D level after allogeneic hematopoietic stem cell transplant', Biology of Blood and Marrow Transplantation, vol. 17, no. 7, pp. 1079-1083. https://doi.org/10.1016/j.bbmt.2010.12.704
Sproat, Lisa ; Bolwell, Brian ; Rybicki, Lisa ; Dean, Robert ; Sobecks, Ronald ; Pohlman, Brad ; Andresen, Steven ; Sweetenham, John ; Copelan, Edward ; Kalaycio, Matt. / Vitamin D level after allogeneic hematopoietic stem cell transplant. In: Biology of Blood and Marrow Transplantation. 2011 ; Vol. 17, No. 7. pp. 1079-1083.
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abstract = "Vitamin D (VD) deficiency can cause osteomalacia, bone pain, muscle weakness, fatigue, and increased risk of fracture, and may precipitate or exacerbate osteopenia and osteoporosis. Patients receiving treatment for acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) may have limited exposure to sunlight and often experience gastrointestinal side effects that may decrease their ability to maintain an adequate VD level. We hypothesized that patients with AML and ALL would have a low VD level after allogeneic hematopoietic cell transplant (HCT), and that these patients would have a high incidence of osteoporosis/osteopenia. We therefore studied the incidence of low VD level and low bone mineral density after HCT. Of 289 patients with AML or ALL undergoing HCT between January 1, 2000, and January 31, 2009, at the Cleveland Clinic, 58 (20.1{\%}) patients had VD testing after HCT. Of these, 52 (89.7{\%}) patients had a low VD level, and 6 (10.3{\%}) had a normal level. Most patients with VD testing had graft-versus-host disease (GVHD) and were taking corticosteroids (94.8{\%} and 98.3{\%}, respectively). Of the 49 patients with VD testing who also had bone mineral density testing, 65{\%} had abnormal (low bone density) results. Only 21{\%} of patients with VD testing were taking VD supplements prior to testing, and 65{\%} had an elevated parathyroid hormone level. We found that most patients did not have VD testing after HCT, but those that did were very likely to have a low level and have low bone mineral density. Those with a low VD level were likely to have received corticosteroids, have GVHD, and have an elevated parathyroid hormone (PTH) level. Given the potential morbidity of low VD level, VD deficiency should be considered after HCT. Prospective study of VD level and its impact on morbidity and mortality after HCT is warranted.",
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