The following is an abstract of “Association of Vitamin A and D Deficiency and Infections in Children Receiving Intensive Induction Therapy for Acute Lymphoblastic Leukemia” published in the June 2024 issue of The Journal. Pediatrics Penkert et al.
This study aimed to evaluate the association between vitamin A or D deficiency at the time of childhood acute lymphoblastic leukemia (ALL) diagnosis and the risk of subsequent infectious complications during induction therapy. It was conducted as an IRB-approved retrospective cohort study and included children newly diagnosed with ALL at St. Jude Children’s Research Hospital from 2007 to 2017. The study measured vitamin D levels, D-binding protein, retinol-binding protein (as a surrogate for vitamin A), and immunoglobulin isotypes in serum samples collected at the time of ALL diagnosis. Cox regression models were used to evaluate the association between these vitamin deficiencies or levels during the 6-week induction phase and infection-related complications.
The study included 378 participants and found that vitamin A and D deficiencies were prevalent, affecting 43% and 17% of the cohort. Findings showed that vitamin D deficiency was significantly associated with an increased risk of febrile neutropenia (adjusted hazard ratio 0.015; 0.015). [aHR] 1.7; p=0.0072), clinically documented infection (aHR 1.73; p=0.025), and possible bacterial infection (aHR 1.86; p=0.008). Interestingly, vitamin A deficiency was associated with a reduced risk of sepsis (aHR 0.19; p=0.027).
In conclusion, this retrospective analysis shows that vitamin D deficiency at the time of ALL diagnosis is associated with an increased risk of common infection-related complications during the induction therapy phase.
These results suggest the potential benefit of evaluating vitamin D supplementation as a preventive strategy to reduce infection risk in pediatric patients with ALL. Further studies are needed to investigate the efficacy of vitamin D supplementation in this setting and to gain a deeper understanding of its underlying mechanisms.
sauce: Science Direct
