Vitamin D Deficiency Impacts Graft-Versus-Host Disease Outcomes

By Patrick Daly - Last Updated: December 20, 2022

In a study published in Clinical Transplantation, researchers evaluated the impact of vitamin D deficiency (VDD) on hematopoietic stem cell transplantation (HSCT) outcomes in patients with thalassemia major (TM).

The authors noted studies on this topic have reached conflicting conclusions due to patient heterogeneity. Based on their data, the authors suggested low vitamin D3 levels prior to HSCT were associated with significant risk for acute graft-versus-host disease (aGVHD).

The investigators examined potential associations between VDD presence prior to HSCT and outcomes after HSCT in a “relatively homogenous” group of patients with TM. All participants had received identical treatment for TM prior to undergoing transplant, as well as the same conditioning and GVHD prophylaxis regimens.

Researchers administered vitamin D 400-800 IU per day for the 6 months following HSCT, including in patients with normal vitamin D3 levels at baseline. Reportedly, patients with VDD prior to HSCT showed an increased rate of aGVHD after transplantation, particularly patients who received a peripheral blood stem cell-sourced graft.

The study’s authors did note that low vitamin D3 levels prior to HSCT did not show any associations with outcomes, including engraftment, viral infections, alloimmunization, chronic GVHD, length of hospitalization, and transfusion independence.

“All patients with TM should be screened for VDD before HSCT,” the authors closed, “and every effort should be made to supplement vitamin D before the transplant in VDD patients.”

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