Increased incidence of chronic GvHD and CMV disease in patients with vitamin D deficiency before allogeneic stem cell transplantation

Von Bahr L, Blennow O, Alm J, Bjorklund A, Malmberg KJ, Mougiakakos D, Le Blanc A, Oefner PJ, Labopin M, Ljungman P, Le Blanc K (2015)

Publication Type: Journal article

Publication year: 2015

Journal

Bone Marrow Transplantation Nature Publishing Group: Open Access Hybrid Model Option B

Book Volume: 50

Pages Range: 1217-23

Journal Issue: 9

DOI: 10.1038/bmt.2015.123

Abstract

Vitamin D has emerged as a central player in the immune system, with its deficiency being implicated in the pathogenesis of several autoimmune diseases, including chronic GvHD. This is a retrospective cohort analysis of 166 patients, who underwent allogeneic hematopoietic stem cell transplantation (HSCT) at the Karolinska University Hospital, evaluating GvHD, graft failure, infectious complications and survival after HSCT in relation to pre-transplantation vitamin D levels. Most of the patients were deficient in vitamin D before HSCT (median 42 nmol/L). In multivariate analysis, vitamin D level before HSCT was identified as a significant independent risk factor for development of cGvHD. The increased incidence of cGvHD was not coupled to better disease-free survival; instead there was a trend towards lower overall survival in the vitamin D-deficient patients. In addition, we found a significant correlation between vitamin D deficiency and incidence of CMV disease, with no case of CMV disease occurring in patients with sufficient levels of vitamin D before HSCT. Our results support a role of vitamin D in immune tolerance following HSCT. These findings could be highly relevant for the care of HSCT patients, and prospective, randomized studies on the effect of vitamin D supplementation are therefore needed.

Authors with CRIS profile

Dimitrios Mougiakakos Professur für Hämatologie/Onkologie mit dem Schwerpunkt Tumorimmunologie

Involved external institutions

Karolinska University Hospital / Karolinska Universitetssjukhuset SE Sweden (SE) Hôpital Saint-Antoine FR France (FR) Universität Regensburg DE Germany (DE) Karolinska Institute SE Sweden (SE)

How to cite

APA:

Von Bahr, L., Blennow, O., Alm, J., Bjorklund, A., Malmberg, K.-J., Mougiakakos, D.,... Le Blanc, K. (2015). Increased incidence of chronic GvHD and CMV disease in patients with vitamin D deficiency before allogeneic stem cell transplantation. Bone Marrow Transplantation, 50(9), 1217-23. https://doi.org/10.1038/bmt.2015.123

MLA:

Von Bahr, L., et al. "Increased incidence of chronic GvHD and CMV disease in patients with vitamin D deficiency before allogeneic stem cell transplantation." Bone Marrow Transplantation 50.9 (2015): 1217-23.

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