Increased incidence of chronic GvHD and CMV disease in patients with vitamin D deficiency before allogeneic stem cell transplantation
Increased incidence of chronic GvHD and CMV disease in patients with vitamin D deficiency before allogeneic stem cell transplantation
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同种异体干细胞移植前维生素 D 缺乏的患者慢性 GvHD 和 CMV 疾病的发生率增加
DOI：
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发表时间：
2015
影响因子：
4.8
通讯作者：
K. Le Blanc
中科院分区：
文献类型：
--
作者：
L. von Bahr;O. Blennow;J. Alm;A. Björklund;Karl;D. Mougiakakos;A. Le Blanc;P. Oefner;M. Labopin;P. Ljungman;K. Le Blanc
维生素D已成为免疫系统的核心参与者，其缺乏与几种自身免疫性疾病的发病机制有关，包括慢性GvHD。这是一项对166例在卡罗林斯卡大学医院接受异基因造血干细胞移植（HSCT）的患者进行的回顾性队列分析，评估了移植前维生素D水平与HSCT后GvHD、移植失败、感染并发症和生存率的关系。大多数患者在HSCT前缺乏维生素D（中位数42 nmol/L）。在多变量分析中，HSCT前的维生素D水平被确定为cGvHD发展的重要独立危险因素。cGvHD发病率的增加并不与更好的无病生存率相关联;相反，维生素D缺乏患者的总生存率有降低的趋势。此外，我们发现维生素D缺乏与CMV疾病的发生率之间存在显著相关性，HSCT前维生素D水平充足的患者中没有发生CMV疾病的病例。我们的研究结果支持维生素D在HSCT后免疫耐受中的作用。这些发现可能与HSCT患者的护理高度相关，因此需要对维生素D补充剂的作用进行前瞻性随机研究。
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.
DOI：
10.1016/j.bbmt.2014.12.001
发表时间：
2015-03
期刊：
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
影响因子：
--
作者：
Jagasia MH;Greinix HT;Arora M;Williams KM;Wolff D;Cowen EW;Palmer J;Weisdorf D;Treister NS;Cheng GS;Kerr H;Stratton P;Duarte RF;McDonald GB;Inamoto Y;Vigorito A;Arai S;Datiles MB;Jacobsohn D;Heller T;Kitko CL;Mitchell SA;Martin PJ;Shulman H;Wu RS;Cutler CS;Vogelsang GB;Lee SJ;Pavletic SZ;Flowers ME
通讯作者：
Flowers ME
影响因子：
4.3
作者：
Wentao Zhu;A. P. Stevens;K. Dettmer;E. Gottfried;S. Hoves;M. Kreutz;E. Holler;A. Canelas;I. Kem
通讯作者：
Wentao Zhu;A. P. Stevens;K. Dettmer;E. Gottfried;S. Hoves;M. Kreutz;E. Holler;A. Canelas;I. Kem
影响因子：
20.3
作者：
Landfried, Karin;Zhu, Wentao;Holler, Ernst
通讯作者：
Holler, Ernst