398 Prevalence of Vitamin D Deficiency in Allogeneic HCT Recipients and Its Association with Graft Versus Host Disease

Track: Poster Abstracts
Saturday, February 14, 2015, 6:45 PM-7:45 PM
Grand Hall CD (Manchester Grand Hyatt)
Linda Dupuis Rosen, RN, OCN , Nursing, Stanford University Medical Center- Stanford Health Care, Stanford, CA
Tara Coghlin Dickson, MS, RD, CSSD , Clinical Nutrition, Stanford University Medical Center- Stanford Health Care, Stanford, CA
Kate Tierney, PhD , Blood and Marrow Transplantation, Stanford University Medical Center, Stanford, CA
Laura Johnston, MD , Blood and Marrow Transplantation, Stanford University Medical Center, Stanford, CA
David Pickham, RN, PhD , Division of General Medical Disciplines, Stanford University School of Medicine, Stanford University Medical Center- Stanford Health Care, Menlo Park, CA
Presentation recording not available for download or distribution as requested by the presenting author.
Purpose: Vitamin D deficiency has been associated with chronic Graft Versus Host Disease (GVHD), and insufficient Vitamin D levels have been shown in patients who have undergone hematopoietic cell transplant (HCT). This pilot study tests the hypothesis that Vitamin D deficiency is prevalent and is associated with acute GVHD (AGVHD) in the immediate 90 days after HCT.   

Methods: Fifty allogeneic subjects were selected from the HCT database based on available bio-samples pretransplant, 30 days, and 90 days post HCT, obtained during 2012-2013. Retrospective clinical data were also obtained. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to determine 25-OH vitamin D (D2, D3 and total) levels at the three time-points. Descriptive analysis was completed using PASW (IBM, V.20).   

Results: 50 subjects (25 male, 25 female), mean age 41±11 years, 48% white (18% Asian, 34% other), were selected. AGVHD was present in 23/49 (~50%) of subjects and 73% had Vitamin D deficiency at baseline (20±8 ng/ml), significantly decreasing at 30 days (16±8 ng/ml, p=.048), and remained constant at 90 days (16±10 ng/ml). Majority of samples were below threshold for Vitamin D (<25 ng/ml, 77%), however no significant relationship to AGVHD was detected (p=.530). For sex, men had greater proportion with low Vitamin D (83% v 63%) and AGVHD (52% v 42%) than women, though not reaching significance (p=.193 & p=.571). For race, all Asian subjects were below threshold for Vitamin D (9/9) and 4 developed AGVHD (44%).

Conclusion: We identify a significant majority of subjects undergoing HCT have Vitamin D deficiency (73%), progressing 30 days post HCT with a disproportionate effect on sex and race. Although we do not detect an association between Vitamin D deficiency and AGVHD, an appropriately powered study is needed to determine whether a relationship exists. Supplementation and monitoring HCT patients for Vitamin D deficiency is warranted. 

Disclosures:
Nothing To Disclose
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