Post‐Transplantation Bone Disease: Prevalence, Monitoring, Prevention, and Management Guidelines

Dahir, Kathryn; Perry, Brandon C.; Jagasia, Shubhada

doi:10.1002/9781118473306.ch15

Cited by 5 publications

(10 citation statements)

References 86 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Institute of Medicine (IOM, 2011) has recommended a daily dietary intake of 400 to 600 international units (IU) of vitamin D for adults up to 70 years and 800 IU for adults over 70 years. Individuals at higher risk for vitamin D deficiency may need 2,000 IU or more daily to maintain sufficient levels (Dahir et al, 2013;Holick et al, 2011). Supplements are available in two different forms: cholecalciferol (vitamin D3) is derived from animal sources and produced in the human body, and ergocalciferol (vitamin D2) is derived from plant sources.…”

Section: Overview Of Vitamin Dmentioning

confidence: 99%

“…Supplements are available in two different forms: cholecalciferol (vitamin D3) is derived from animal sources and produced in the human body, and ergocalciferol (vitamin D2) is derived from plant sources. Ergocalciferol is not as potent as cholecalciferol and may need to be dosed at a higher level to attain sufficient levels (Dahir et al, 2013). Repletion of vitamin D has been shown to have positive health benefits, as patients in the general population who have adequate vitamin D levels have a decreased incidence of fractures and falls (Holick et al, 2011;Simmons et al, 2013).…”

Section: Overview Of Vitamin Dmentioning

confidence: 99%

“…Screening for vitamin D deficiency is recommended by the Endocrine Society Clinical Practice Guidelines for high-risk populations and HSCT patients (Dahir et al, 2013;Holick et al, 2011). The major circulating form of vitamin D is 25-hydroxy and most accurately indicates vitamin D status (Dahir et al, 2013). A serum 25(OH)D level is the standard test used to measure vitamin D (Holick et al, 2011).…”

Section: Vitamin D In the Hsct Patientmentioning

confidence: 99%

“…In the general population, vitamin D deficiency has been defined by the Institute of Medicine as < 20 ng/mL and insufficiency as 21 to 29 ng/ mL (Durcan & Petri, 2016). Expert recommendations include a goal 25(OH)D level within 20 to 50 ng/mL (Dahir et al, 2013). Guidelines have been established regarding the appropriate supplementation of vitamin D because of its important role in many biological processes.…”

Section: Vitamin D In the Hsct Patientmentioning

confidence: 99%

“…atients undergoing hematopoietic stem cell transplant (HSCT) are at high risk for vitamin D deficiency before and after transplant, and more so than the general population (Urbain, Ihorst, Biesalski, & Bertz, 2012;Wallace et al, 2015). The prevalence of vitamin D deficiency has been reported to be as high as 70% before transplant and 90% after transplant (Dahir, Perry, & Jagasia, 2013).…”

mentioning

confidence: 99%

See 4 more Smart Citations

Impact of a Replacement Algorithm for Vitamin D Deficiency in Adult Hematopoietic Stem Cell Transplant Patients

Kenny

Collum

Featherstone

et al. 2019

JADPRO

View full text Add to dashboard Cite

Adults undergoing hematopoietic stem cell transplant (HSCT) are at risk for vitamin D deficiency. After HSCT, exposure to sunlight is restricted, and patients may experience poor nutrition and malabsorption from HSCT-related side effects. Vitamin D affects bone health and immunologic processes. The aim of this project is to establish a process for monitoring and treating vitamin D deficiency and to evaluate if therapeutic vitamin D levels are attainable posttransplant using an HSCT vitamin D replacement algorithm. A multidisciplinary group led by advanced practice providers established a workflow for monitoring and supplementing vitamin D and created an HSCT vitamin D replacement guideline. The medical records of 144 adult HSCT patients were reviewed, and the records of another 72 patients were reviewed a year later. Historical baseline data before the intervention found that 81% of patients were vitamin D deficient and 30% received supplementation. Postintervention and at 1-year follow-up, 76% and 65% of patients were vitamin D deficient before transplant and 97.1% and 100%, respectively, received supplementation for vitamin D deficiency. Post-HSCT compliance with monitoring demonstrated that approximately 91% of patients had a vitamin D level checked within 6 months of transplant. After implementation of the algorithm, there was a statistically significant difference (p < .001) between deficient vitamin D levels pretransplant (72.9%) and posttransplant (26.4%). Results demonstrate sustained compliance over a 2-year period with monitoring and supplementation of vitamin D pre-and peritransplant. Aggressive vitamin D repletion posttransplant decreased the incidence of vitamin D deficiency in HSCT patients. Further study is needed to investigate the long-term effects of vitamin D repletion on posttransplant complications.

show abstract

Section: Overview Of Vitamin Dmentioning

confidence: 99%

Section: Overview Of Vitamin Dmentioning

confidence: 99%

Section: Vitamin D In the Hsct Patientmentioning

confidence: 99%

Section: Vitamin D In the Hsct Patientmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Impact of a Replacement Algorithm for Vitamin D Deficiency in Adult Hematopoietic Stem Cell Transplant Patients

Kenny

Collum

Featherstone

et al. 2019

JADPRO

View full text Add to dashboard Cite

show abstract

Loading dose vitamin D3 improves vitamin D insufficiency in adults undergoing hematopoietic stem cell transplantation: A randomized controlled trial

Bai,

Lee,

Limvorapitak

et al. 2023

PLoS ONE

View full text Add to dashboard Cite

Allogeneic hematopoietic stem cell transplant (aHSCT) patients are well known to be at high risk of vitamin D (vit D) deficiency. This study assessed whether a loading dose (100,000 IU) of vitamin D3 pre-aHSCT could effectively achieve and maintain sufficient post-transplant vit D levels (serum total 25 hydroxy vitamin D (25(OH)D) ≥ 75nmol/L). Dual-energy X-ray absorptiometry (DXA) was also conducted for bone health evaluation. 74 patients were enrolled and randomly assigned, in a 1:1 ratio, either to the high vit D group (single loading dose (100,000 IU) plus 2,000 IU vit D3 daily) or the control group (2,000 IU vit D3 daily). Vit D levels were measured at three time points (baseline, day 30 and day 100 post-aHSCT). At baseline, fewer than 50% patients had a sufficient 25(OH)D (control: 42.9%; high vit D: 43.6%). The proportion of patients with sufficient 25(OH)D (nmol/L) was increased at day 30 and day 100, with a trend of higher proportion in the high vit D group at day 30 (high vit D vs. control: 89.7% vs. 74.3%, p = 0.08). The increased 25(OH)D was significantly higher in the high vit D group at day 30 (high vit D vs. control: 29±25.2 vs. 14 ±21.9, p = 0.01). Insufficient vit D level before transplant (baseline) was an independent risk factor for vit D insufficiency (serum 25(OH)D < 75nmol/L) post-aHSCT (OR = 4.16, p = 0.03). DXA suggested significant bone loss for total hip in both groups, and in the femoral neck for the control group only. In conclusion, single loading dose vitamin D3 significantly increased total 25(OH)D levels at day 30 post-transplant, and the intervention was especially beneficial for patients with baseline vit D insufficiency. We acknowledge that the primary outcome at day 100 post-aHSCT indicating superiority of loading dose versus daily dose supplementation was not met.

show abstract

Effect of Vitamin D on Graft-Versus-Host Disease

Rodríguez-Gil¹,

Carrillo‐Cruz²,

Marrero-Cepeda³

et al. 2022

Preprint

View full text Add to dashboard Cite

The different cell subsets of the immune system express vitamin D receptor (VDR). Through VDR, vitamin D exerts different functions which influences on immune responses, as previously shown in different preclinical models. Based on this background, retrospective studies have explored the impact of vitamin D levels on the outcome of patients undergoing allogeneic hematopoietic stem cell transplantation, showing that vitamin D deficiency is related to an increased risk of complications, especially graft-versus-host disease. These results have been confirmed in a prospective cohorts trial, although further studies are required to confirm this data. In addition, the role of vitamin D on the treatment of hematologic malignancies has also been explored. Considering this dual effect both on the immune system as well as on tumor cells in patients with hematologic malignancies, vitamin D might be useful in this setting both to decrease graft-versus-host disease and relapse rates.

show abstract

Post‐Transplantation Bone Disease: Prevalence, Monitoring, Prevention, and Management Guidelines

Cited by 5 publications

References 86 publications

Impact of a Replacement Algorithm for Vitamin D Deficiency in Adult Hematopoietic Stem Cell Transplant Patients

Impact of a Replacement Algorithm for Vitamin D Deficiency in Adult Hematopoietic Stem Cell Transplant Patients

Loading dose vitamin D3 improves vitamin D insufficiency in adults undergoing hematopoietic stem cell transplantation: A randomized controlled trial

Effect of Vitamin D on Graft-Versus-Host Disease

Contact Info

Product

Resources

About