According to Lars Klingen Gjærde, and colleagues, lower pre-transplantation plasma vitamin E levels are associated with increased acute graft-versus-host disease (GVHD) after myeloablative allogeneic hematopoietic cell transplantation (allo-HCT). However, in a follow-up study, Gjærde and team “did not find support for an association between lower pre-transplantation vitamin E levels and increased acute GVHD grade II–IV after allo-HCT with non-myeloablative conditioning.”
The study was presented at the Transplantation & Cellular Therapy 2022 Tandem Meetings from the American Society for Transplantation and Cellular Therapy (ASTCT) and the Center for International Blood & Marrow Transplant Research (CIBMTR). The investigators measured plasma vitamin E levels with high-performance liquid chromatography in pre-transplantation samples from a total of 194 patients.
The authors reported that the patients’ median (Q1, Q3) pre-transplantation plasma vitamin E level was 32.3 (26.4, 40.4) µmol/L—and that “no patients had a vitamin E level below the normal reference range.” Levels were higher in female patients and patients with acute leukemia. The researchers noted that acute GVHD grade II-IV developed in 33 (17%) patients at a median of 34 (18, 62) days after allo-HCT.
Notably, the study found that pre-transplantation vitamin E levels were similar in patients who developed acute GvHD grade II–IV relative to levels among patients who did not. The authors calculated that an increase in the pre-transplantation vitamin E level from 26.4 (Q1) to 40.4 (Q3) µmol/L was associated with an odds ratio of acute GVHD grade II–IV of 1.17 (95% confidence interval [CI]: 0.64–2.12).
In closing, Gjærde and the study’s collaborators proposed that, “the potential protective effects of vitamin E may not be efficacious in the reduced inflammatory response following non-myeloablative conditioning.”