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骨化三醇预防接受造血干细胞移植的范可尼贫血患者口腔黏膜炎:一项双盲、随机、安慰剂对照试验

Calcitriol for Oral Mucositis Prevention in Patients With Fanconi Anemia Undergoing Hematopoietic SCT: A Double-Blind, Randomized, Placebo-Controlled Trial.

作者信息

Hamidieh Amir Ali, Sherafatmand Mona, Mansouri Ava, Hadjibabaie Molouk, Ashouri Asieh, Jahangard-Rafsanjani Zahra, Gholami Kheirollah, Javadi Mohammad Reza, Ghavamzadeh Ardeshir, Radfar Mania

机构信息

1Hematology-Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; 3Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran; and 4Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Am J Ther. 2016 Nov/Dec;23(6):e1700-e1708. doi: 10.1097/MJT.0000000000000269.

Abstract

Fanconi anemia is a rare inherited aplastic anemia, which is cured only by hematopoietic stem-cell transplantation (HSCT). One of the most debilitating complications of high-dose chemotherapy regimen before HSCT is oral mucositis (OM), which occurs frequently in this population. Vitamin D has identified immunoregulatory, anti-inflammatory, and antioxidant role. This study was designed to examine the efficacy of vitamin D in the prevention of OM in patients with Fanconi anemia undergoing allogenic HSCT. Twenty-eight patients were enrolled in the study. They received either calcitriol (0.025 μg) or placebo capsule once daily, from the first day of chemotherapy schedule for 14 consecutive days. Incidence of OM was assessed as the primary outcome. Moreover, the association of baseline vitamin D level with OM was evaluated. In this study, calcitriol did not change OM incidence (P = 1) and severity (P = 0.54) significantly; however, a significant association of baseline vitamin D level with OM complete resolution was found (P = 0.03; hazard ratio, 1.01; 95% confidence interval, 1.00-1.01). In conclusion, we did not find considerable benefits of calcitriol in the prevention of OM. However, further studies with bigger sample size and different calcitriol supplementation schedules are needed to confirm these findings.

摘要

范可尼贫血是一种罕见的遗传性再生障碍性贫血,仅通过造血干细胞移植(HSCT)才能治愈。HSCT前高剂量化疗方案最使人衰弱的并发症之一是口腔黏膜炎(OM),在该人群中经常发生。维生素D具有免疫调节、抗炎和抗氧化作用。本研究旨在探讨维生素D在预防接受异基因HSCT的范可尼贫血患者发生OM中的疗效。28例患者纳入本研究。从化疗方案的第一天起,他们连续14天每天接受骨化三醇(0.025μg)或安慰剂胶囊。OM的发生率作为主要结局进行评估。此外,还评估了基线维生素D水平与OM的相关性。在本研究中,骨化三醇并未显著改变OM的发生率(P=1)和严重程度(P=0.54);然而,发现基线维生素D水平与OM完全缓解之间存在显著相关性(P=0.03;风险比,1.01;95%置信区间,1.00-1.01)。总之,我们未发现骨化三醇在预防OM方面有显著益处。然而,需要进一步开展更大样本量和不同骨化三醇补充方案的研究来证实这些发现。

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