Vitamin D deficiency is not associated with graft versus host disease after hematopoietic stem cell transplantation: A meta-analysis.

Kanhatai Chiengthong, Wisit Cheungpasitporn, Charat Thongprayoon, Ploypin Lertjitbanjong, Liam D Cato, Tarun Bathini, Patompong Ungprasert, Michael A Mao, Ronpichai Chokesuwattanaskul

Journal: Journal of evidence-based medicine 2021;13(3):183-191

PMID: 32369679

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Abstract

OBJECTIVE

Vitamin D status plays an important role in immunoregulation, and a deficiency is believed to be related to Graft Versus Host Disease (GVHD) in patients after hematopoietic stem cell transplantation (HSCT). We aim to study the association between vitamin D deficiency and GVHD after HSCT.

METHODS

A literature search was conducted utilizing MEDLINE, EMBASE, and The Cochrane Library Database from inception to July 2019. Eligible studies were required to be clinical trials or observational studies (cohort, case-control, or cross-sectional studies); provide data to calculate the odds ratios (OR) of GVHD in HSCT patients with vitamin D deficiency. Two reviewers independently extracted the data and assessed the risk of bias. Pooled odds ratios (OR) with 95% confidence interval (CI) were estimated using random-effects meta-analysis through the Comprehensive Meta-Analysis 3.3 software.

RESULTS

In total, 8 observational studies consisting of 1335 HSCT patients were enrolled in this systematic review. Overall, there was no significant association between vitamin D deficiency and acute GVHD (OR = 1.06, 95% CI 0.74-1.53, P > 0.05). There was no significant association between vitamin D deficiency and chronic GVHD (OR = 1.75, 95% CI 0.72-4.26, P > 0.05). Funnel plots and Egger regression asymmetry test were performed and showed no publication bias.

CONCLUSION

There is not a statistically significant association between vitamin D deficiency and neither acute nor chronic GVHD.

Address: Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.; King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.; Department of Medicine, University of Mississippi Medical Center, Mississippi, Jackson.; Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.; Department of Internal Medicine, Bassett Medical Center, Cooperstown, New York.; University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.; Department of Internal Medicine, University of Arizona, Tucson, Arizona.; Clinical Epidemiology Unit, Department of Research and Development, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.; Department of Internal Medicine, Mayo Clinic, Jacksonville, Florida.; Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

DOI: 10.1111/jebm.12383

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MeSH Terms: Graft vs Host Disease, Hematopoietic Stem Cell Transplantation, Humans, Vitamin D Deficiency