Is there a relationship between vitamin D levels and graft versus host disease?

Abstract

Objective: Vitamin D deficiency is common in adult patients undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT). Since vitamin D is an important regulatory factor for the immune system, vitamin D deficiency may have effects on antitumor activity, relapse rates, graft versus host disease (GVHD) occurrence and infection rates in allo-HSCT. We aimed to investigate the effects of vitamin D levels on the outcome of allo-HSCT.

Material and methods: This study included 211 patients who underwent allo-HSCT at seven transplant centers in Türkiye. The impact of pretransplant vitamin D level on overall survival (OS), relapse rate, GVHD occurrence and engraftment times was analyzed retrospectively RESULTS: Pretransplant vitamin D levels were not related to the neutrophil engraftment day (p: 0.887), relapse rate (p: 0.433) and GVHD occurrence (p: 0.391). At a median follow-up of 14 months, OS was 84.8 % and median OS was not reached. Univariate Cox Regression analysis showed that higher levels of vitamin D (>12 ng/mL) affected the survival rates (p = 0.029) (HR: 0.392: 95 % CI: 10.170-0.907).

Conclusion: In our study, pretransplant vitamin D levels were not related to GVHD occurrence, relapse rate and engraftment times. However, we found that higher levels of pretransplant vitamin D levels (threshold is 12 ng/mL) were associated with increased survival. Further studies with a larger population are necessary to reveal the role of vitamin D in patients undergoing allo-HSCT.