Variations in 1α,25-dihydroxyvitamin D3 and 25-hydroxyvitamin D3 serum levels during allogeneic bone marrow transplantation

Kreutz, Marina; Eißner, Günther; Hahn, J.; Andreesen, Reinhard; Drobnik, Wolfgang; Holler, Ernst

doi:10.1038/sj.bmt.1704448

Cited by 36 publications

(30 citation statements)

References 10 publications

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“…Second, in 2012 we also started a supplementation with cholecalciferol (vitamin D), because a potential impact of vitamin D on immunoregulation and maintenance of bacterial diversity has been reported. 13 Nevertheless, our observations suggest possible preservation of pre-transplant intestinal microbiota diversity and, thereby, possibly prevention of inflammatory processes by the use of rifaximin.…”

Section: Discussionmentioning

confidence: 94%

Rifaximin preserves intestinal microbiota balance in patients undergoing allogeneic stem cell transplantation

Weber

Oefner

Dettmer

et al. 2016

Bone Marrow Transplant

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Intestinal dysbiosis has been associated with acute gastrointestinal GvHD and poor outcome following allogeneic stem cell transplantation (ASCT). To assess the effect of a switch in 2012 from ciprofloxacin/metronidazole to rifaximin for gut decontamination on intestinal microbiota composition and ASCT outcome, we retrospectively analyzed 394 patients receiving ASCT from September 2008 through June 2015. In 131 and 90 patients, respectively, urinary 3-indoxyl sulfate levels and intestinal enterococcal load were measured before conditioning and weekly within the first 28 days after ASCT. The use of rifaximin correlated with lower enterococcal positivity (6.9 vs 21.9%, P = 0.05) and higher urinary 3-indoxyl sulfate concentrations (10.5 vs 4.6 μmoL/mmoL crea, P o0.001) after ASCT. Patients on rifaximin showed lower 1-year transplant-related mortality (P = 0.04) and higher overall survival (P = 0.008). Treatment of infectious complications with systemic antibiotics did not abrogate the beneficial effects of rifaximin on intestinal microbiota composition in the early course of ASCT and outcome. The data underscore the importance of maintaining a diverse population of symbiotic and mutualistic bacteria in the gut on ASCT outcome.

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Section: Discussionmentioning

confidence: 94%

Rifaximin preserves intestinal microbiota balance in patients undergoing allogeneic stem cell transplantation

Weber

Oefner

Dettmer

et al. 2016

Bone Marrow Transplant

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“…[7][8][9][10] Except for one report by Kyle et al 11 on the development of lean body mass, there were until now no longitudinal data on nutritional status and body composition in the early post-transplant period, although several reports showed that depletion of micronutrients, mainly vitamin D, is common before and after alloHCT. [12][13][14] There are now many nutritional parameters available and validated for cancer patients. The phase angle is one of them.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal follow-up of nutritional status and its influencing factors in adults undergoing allogeneic hematopoietic cell transplantation

Urbain

Birlinger

Lambert

et al. 2012

Bone Marrow Transplant

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There are few longitudinal data on nutritional status and body composition of patients undergoing allogeneic hematopoietic cell transplantation (alloHCT). We assessed nutritional status of 105 patients before alloHCT and its course during the early posttransplant period to day þ 30 and day þ 100 via weight history, body mass index (BMI) normalized for gender and age, Subjective Global Assessment, phase angle normalized for gender, age, and BMI, and fat-free and body fat masses. Furthermore, we present a multivariate regression model investigating the impact of factors on body weight. At admission, 23.8% reported significant weight losses (45%) in the previous 6 months, and we noted 31.5% with abnormal age-and sex-adjusted BMI values (p10th, X90th percentiles). BMI decreased significantly (Po0.0001) in both periods by 11% in total, meaning a weight loss of 8.6 ± 5.7 kg. Simultaneously, the patients experienced significant losses (Po0.0001) of both fat-free and body fat masses. Multivariate regression model revealed clinically relevant acute GVHD (parameter estimate 1.43; P ¼ 0.02) and moderate/severe anorexia (parameter estimate 1.07; P ¼ 0.058) as independent factors influencing early weight loss. In conclusion, our results show a significant deterioration in nutritional status during the early post-transplant period. Predominant alloHCT-associated complications such as anorexia and acute GVHD became evident as significant factors influencing nutritional status.

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“…Although vitamin D deficiency could be explained by low sun exposure, reduced dietary vitamin D and use of corticosteroids in some of chemotherapeutic regimens, oral vitamin D supplements were insufficient to restore 25-hydroxyvitamin D 3 levels to normal [33]. The levels of the active 1,25-hydroxy-vitamin D 3 have also been shown to be low in patients with allogenic HSCT [34]. The authors hypothesized that during aplasia, there is a reduction of extrarenal 1-a-hydroxylation of 25-hydroxy-vitamin D 3 due to the lack of contribution from the leucocytes.…”

Section: Discussionmentioning

confidence: 99%

Incidence and severity of early electrolyte abnormalities following autologous haematopoietic stem cell transplantation

Philibert

Desmeules

Filion

et al. 2007

Nephrology Dialysis Transplantation

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Background. Haematopoietic stem cell transplantation (HSCT) has gained worldwide acceptance as a therapeutic option for many haematological and non-haematological conditions. Local experience supports that electrolyte abnormalities are quite common; however, the incidence and timing of these abnormalities are unknown. Method. We conducted a retrospective descriptive study of 48 consecutive adult patients in order to study the incidence and the timing of electrolyte abnormalities following autologous HSCT. Clinical and pharmacological data were collected by the review of patient charts. Potassium, magnesium, calcium, phosphorus and albumin levels were retrieved from the laboratory. Results. HSCT was performed for multiple myeloma (28/48), lymphoma (8/48), Hodgkin disease (4/48), amyloidosis (4/48) and other neoplasia (4/48). At baseline, 21% of patients (10/48) had low electrolyte levels. Following autologous HSCT, hypokalaemia occurred in 81% (39/48), hypomagnesaemia in 67% (32/48), hypocalcaemia in 49% (17/35) and hypophosphataemia in 91% (39/43) of the patients. The nadir of the electrolyte levels occurred between day 8 and 10 after stem cell transplant while the engraftment occurred at day 11.6 AE 0.6. The use of amphotericin B and furosemide was associated with more pronounced hypokalaemia and hypomagnesaemia. Hypocalcaemia was more pronounced in patients with multiple myeloma. High levels of electrolytes occurred in only 25% of the patients, none of which required specific treatment. Conclusion. We conclude that low electrolyte levels are extremely common after HSCT and the pathophysiology of these abnormalities are complex and multifactorial.

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Variations in 1α,25-dihydroxyvitamin D3 and 25-hydroxyvitamin D3 serum levels during allogeneic bone marrow transplantation

Cited by 36 publications

References 10 publications

Rifaximin preserves intestinal microbiota balance in patients undergoing allogeneic stem cell transplantation

Rifaximin preserves intestinal microbiota balance in patients undergoing allogeneic stem cell transplantation

Longitudinal follow-up of nutritional status and its influencing factors in adults undergoing allogeneic hematopoietic cell transplantation

Incidence and severity of early electrolyte abnormalities following autologous haematopoietic stem cell transplantation

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