Vitamin D Deficiency and Oral Mucositis in Hematopoietic Stem Cell Transplantation: A Cross-Sectional Observation

Abstract

Backgrounds: One of the most frequent complications of high-dose chemotherapy regimen before hematopoietic stem cell transplantation (HSCT) is oral mucositis (OM). Vitamin D (VD) has well-known immunoregulatory, anti-inflammatory, and antioxidant properties.This study aimed to evaluate the association of pre-HSCT VD levels with OM as well as neutrophil and platelet engraftments in patients with multiple myeloma, Hodgkin’s and non-Hodgkin’s lymphoma after autologous HSCT.

Methods: A sample of 71 patients was enrolled after obtaining informed consent. Serum samples were collected in the morning prior to the administration of conditioning regimen to measure the 25-OH-D. OM was examined daily during hospital stay. The World Health Organization (WHO) scale was used for scoring the OM. Absolute neutrophil count and platelet count were determined daily from transplantation until engraftment.

Results: Patients aged 18-65 years. Mean length of hospital stay was 15.8±5.7 days. OM was detected in 44/71 (62.0%) of patients. Mean time to the engraftment of neutrophils and platelets were 11.8±4.0 and 17.2±7.3 days, respectively. Mean level of 25-OH-D was 17.5±14.0 ng/ml. VD deficiency (<20 ng/ml) was diagnosed in 51/71 (71.8%) of patients. No association between the 25-OH-D levels and incidence of OM (P=0.69) or OM grade 3-4 (P=0.46) was found. No significant correlations were detected between the 25-OH-D and engraftment time of neutrophils (P=0.46) or platelets (P=0.17).

Conclusions: The prevalence of VD deficiency was high among adult HSCT patients at the time of transplantation. No association was found between the pre-HSCT VD level and OM or engraftment time.