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Vitamin D and A deficiency and infection-related complications in pediatric patients with ALL undergoing intensive induction chemotherapy

By Dylan Barrett

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Aug 19, 2024

Learning objective: After reading this article, learners will be able to cite a new clinical development in acute lymphoblastic leukemia.


A retrospective analysis assessed the association between vitamin D or A deficiency and infectious outcomes during intensive induction chemotherapy in pediatric patients with newly diagnosed acute lymphoblastic leukemia (ALL).1 This analysis included a subset of 378 patients aged <19 years treated between October 2007 and March 2017 at St. Jude Children’s Research Hospital in the Total 16 study (NCT00549848).Results from this analysis were published in The Journal of Pediatrics by Penkert et al.1

Key learnings

Vitamin D deficiency in pediatric patients with ALL undergoing intensive induction chemotherapy was associated with an increased risk of:

  • Febrile neutropenia (adjusted hazard ratio [aHR], 1.70; p = 0.0072) 
  • Febrile neutropenia with clinically documented infection (aHR, 3.02; p = 0.0011) 
  • Any clinically documented infection (aHR, 1.73; p = 0.0245)

Vitamin A deficiency was linked with a decreased risk of suspected sepsis (aHR, 0.19; p = 0.0274), but not with other infectious complications, suggesting a complex relationship between vitamin A levels and immune response in pediatric patients​.

This study emphasizes the importance of maintaining adequate vitamin D levels to potentially reduce infection-related complications in pediatric patients receiving chemotherapy; further studies assessing the effects of vitamin supplementation during treatment are warranted.

References

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