Peter, Katrin and Siska, Peter J. and Roider, Tobias and Matos, Carina and Bruns, Heiko and Renner, Kathrin and Singer, Katrin and Weber, Daniela and Guellstorf, Martina and Kroeger, Nicolaus and Wolff, Daniel and Herr, Wolfgang and Ayuk, Francis and Holler, Ernst and Stark, Klaus and Heid, Iris M. and Kreutz, Marina (2021) 1,25-dihydroxyvitamin-D3 but not the clinically applied marker 25-hydroxyvitamin-D3 predicts survival after stem cell transplantation. BONE MARROW TRANSPLANTATION, 56. pp. 419-433. ISSN 0268-3369, 1476-5365
Full text not available from this repository. (Request a copy)Abstract
The serum level of 25-hydroxyvitamin-D3 is accepted as marker for a person's vitamin D status but its role for the outcome of allogeneic hematopoietic stem cell transplantation (HSCT) is controversially discussed. The impact of 1,25-dihydroxyvitamin-D3 on HSCT outcome, however, has never been studied. In a discovery cohort of 143 HSCT patients we repeatedly (day -16 to 100) measured 1,25-dihydroxyvitamin-D3 and in comparison the well-established marker for serum vitamin D status 25-hydroxyvitamin-D3. Only lower 1,25-dihydroxyvitamin-D3 levels around HSCT (day -2 to 7, peritransplant) were significantly associated with higher 1-year treatment-related mortality (TRM) risk (Mann-Whitney U test,P = 0.001). This was confirmed by Cox-model regression without and with adjustment for baseline risk factors and severe acute Graft-versus-Host disease (aGvHD; unadjustedP = 0.001, adjustedP = 0.005). The optimal threshold for 1,25-dihydroxyvitamin-D3 to identify patients at high risk was 139.5 pM. Also in three replication cohorts consisting of altogether 365 patients 1,25-dihydroxyvitamin-D3 levels below 139.5 pM had a 3.3-fold increased risk of TRM independent of severe aGvHD compared to patients above 139.5 pM (Cox-model unadjustedP < 0.0005, adjustedP = 0.001). Our data highlight peritransplant 1,25-dihydroxyvitamin-D3 levels but not the commonly monitored 25-hydroxyvitamin-D3 levels as potent predictor of 1-year TRM and suggest to monitor both vitamin D metabolites in HSCT patients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | VITAMIN-D-RECEPTOR; ALLOGENEIC HEMATOPOIETIC SCT; VERSUS-HOST DISEASE; D DEFICIENCY; MONOCYTE RECOVERY; REJECTION; OUTCOMES; 1-ALPHA,25-DIHYDROXYVITAMIN-D-3; ASSOCIATIONS; FLUDARABINE; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) Medicine > Institut für Epidemiologie und Präventivmedizin > Lehrstuhl für Genetische Epidemiologie |
| Depositing User: | Petra Gürster |
| Date Deposited: | 15 Apr 2021 09:09 |
| Last Modified: | 15 Apr 2021 09:09 |
| URI: | https://pred.uni-regensburg.de/id/eprint/43980 |
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