Pediatric Cancer Center Barcelona, Hospital Sant Joan de Déu, Barcelona, Spain.
J Pediatr Hematol Oncol. 2023 Nov 1;45(8):e953-e958. doi: 10.1097/MPH.0000000000002762. Epub 2023 Oct 2.
Vitamin D deficiency has become a matter of concern in pediatric cancer patients. A relationship between neuroblastoma and Vitamin D signaling pathways has been revealed with interest in the antiproliferative and antiinvasive properties of vitamin D. Our aim is to describe the prevalence of Vitamin D deficiency among children with high-risk neuroblastoma (HR-NB) and to explore its association with disease status.
In all, 182 patients with HR-NB were managed at our center from 2017 to 2021. Serum 25(OH)D levels were tested at the first blood analysis performed and correlated with clinical data and disease status.
One hundred forty-eight (81.4%) had low 25(OH)D levels (48.4% categorized as deficiency (25(OH)D below 20 ng/mL) and 33.0% as insufficiency (25(OH)D 20 to 30 ng/mL). Median Vitamin D level was 20.2 ng/mL. Vitamin D levels were not associated with race or sex. Although malnourished patients had lower median 25(OH)D levels(11.1 ng/mL), no statistical association was observed with Vitamin D deficiency. There was no association between Vitamin D levels and disease status. An inverse correlation was found between age and vitamin D levels ( P =0.0040).
A concerning high prevalence of low Vitamin D levels affects more than two-thirds of patients with HR-NB in our cohort, regardless of the disease status at the time of evaluation. Older children are at a higher risk for deficient levels of vitamin D.
维生素 D 缺乏症已成为儿科癌症患者关注的问题。神经母细胞瘤与维生素 D 信号通路之间存在相关性,人们对维生素 D 的抗增殖和抗侵袭特性产生了兴趣。我们的目的是描述高危神经母细胞瘤(HR-NB)患儿维生素 D 缺乏的发生率,并探讨其与疾病状态的关系。
2017 年至 2021 年,我们中心共收治了 182 例 HR-NB 患儿。在首次血液分析时检测血清 25(OH)D 水平,并与临床数据和疾病状态相关联。
148 例(81.4%)患儿 25(OH)D 水平较低(48.4%归类为缺乏症(25(OH)D 低于 20ng/mL),33.0%归类为不足症(25(OH)D 20-30ng/mL)。维生素 D 中位数水平为 20.2ng/mL。维生素 D 水平与种族或性别无关。虽然营养不良的患儿 25(OH)D 中位数水平较低(11.1ng/mL),但与维生素 D 缺乏症无统计学关联。维生素 D 水平与疾病状态之间也没有关联。年龄与维生素 D 水平呈负相关(P=0.0040)。
我们的队列中超过三分之二的 HR-NB 患儿存在令人担忧的低维生素 D 水平发生率,无论评估时的疾病状态如何。年龄较大的儿童更有可能缺乏维生素 D。