Hong Sanghee, Ferraro Christina S, Hamilton Betty K, Majhail Navneet S
Blood and Marrow Transplant Program, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
Bone Marrow Transplant. 2020 Nov;55(11):2060-2070. doi: 10.1038/s41409-020-0904-7. Epub 2020 Apr 25.
Vitamin D plays an essential role in bone health, immune tolerance, and immune modulation. Autologous and allogeneic hematopoietic cell transplantation (HCT) recipients are at increased risk of vitamin D deficiency, which may increase risks of bone loss and fracture, graft-versus-host disease (GVHD), and relapse, and can delay hematologic and immune recovery following HCT. Growing evidence indicates that vitamin D may have a role as an immunomodulator, and supplementation during HCT may decrease the risk of GVHD, infection, relapse, and mortality. In this paper, we review the role of vitamin D and its association with HCT outcomes and discuss prevention and treatment of vitamin D deficiency after HCT in adult recipients. We review the role of monitoring of vitamin D levels pre- and post-HCT and its supplementation in appropriate patients. We also review the use of bone densitometry prior to HCT and in long-term follow-up and the treatment of osteoporosis in this high-risk population.
维生素D在骨骼健康、免疫耐受和免疫调节中起着至关重要的作用。自体和异基因造血细胞移植（HCT）受者维生素D缺乏风险增加，这可能会增加骨质流失和骨折、移植物抗宿主病（GVHD）及复发的风险，并可能延迟HCT后的血液学和免疫恢复。越来越多的证据表明，维生素D可能具有免疫调节作用，HCT期间补充维生素D可能会降低GVHD、感染、复发及死亡的风险。在本文中，我们综述了维生素D的作用及其与HCT结局的关联，并讨论了成年受者HCT后维生素D缺乏的预防和治疗。我们回顾了HCT前后监测维生素D水平的作用及其在合适患者中的补充情况。我们还回顾了HCT前及长期随访中骨密度测定的应用以及该高危人群骨质疏松症的治疗。
