25-Hydroxyvitamin D Concentrations and Overall Survival in Autologous Hematopoietic Stem Cell Transplant Subjects

Abstract

Objectives: To determine associations between mean pre-transplant 25-hydroxyvitamin D concentrations and transplant related survival outcomes in individuals undergoing autologous hematopoietic stem cell transplant (AHSCT) for the treatment of multiple myeloma or lymphoma.

Methods: This IRB approved retrospective cohort study was performed at Seattle Cancer Care Alliance (SCCA) and the Fred Hutchinson Cancer Research Center in Seattle, Washington. Data were collected from the electronic medical records of 132 consented adults diagnosed with multiple myeloma (70), and lymphoma (62), which included mean pre- and post-transplant total 25(OH)D concentrations, age, gender, race, ethnicity, geographic residence, timing of blood draw, body mass index (BMI), % ideal body weight (%IBW), and supplement use. Pre-transplant 25(OH)D concentrations and vitamin D status were compared against all parameters on subjects in order to establish a relationship.

Results: Over half (59%) of subjects were determined to be insufficient in vitamin D with mean pre-transplant 25(OH)D concentrations less than 30 ng/mL (p = <0.001, t-test); 82% of subjects were over the age of 50; 98.5% of subjects reported primary residence in northern states; over 60% were considered overweight or obese; and the majority of subjects (68%) reported the use of a vitamin D-containing supplement at the time of arrival to SCCA. Supplement use was positively correlated with mean pre-transplant 25(OH)D concentrations (p = 0.014, ANOVA). Pre-transplant vitamin D status (insufficient vs sufficient) had no significant impact on survival in subjects post AHSCT [HR = 0.99 (95% CI 0.45-2.20) Log-rank p = 0.997].

Conclusion: Despite vast differences in pre-transplant 25(OH)D concentrations and the use of vitamin D containing supplements over half of this sample had insufficient mean pre-transplant 25(OH)D concentrations at the time of arrival to SCCA. Based on our findings and previous studies it is a reasonable rationale to continue this investigation in a larger sample.