%0 Journal Article
%T Association of Vitamin A and D Deficiencies with Infectious Outcomes in Children Undergoing Intensive Induction Therapy for Acute Lymphoblastic Leukemia.
%A Penkert RR
%A Jones BG
%A Tang L
%A Su Y
%A Jeha S
%A Yang J
%A Yang W
%A Ferrolino J
%A Strength R
%A Pui CH
%A Cross SJ
%A Hurwitz JL
%A Wolf J
%J J Pediatr
%V 273
%N 0
%D 2024 Jun 14
%M 38880379
%F 6.314
%R 10.1016/j.jpeds.2024.114148
%X <B>OBJECTIVE: </B>To evaluate the association between deficiency of vitamin A or D at diagnosis of pediatric acute lymphoblastic leukemia (ALL) and subsequent infectious complications during induction therapy.<BR><B>METHODS: </B>We conducted an institutional review board-approved, retrospective cohort study of children with newly diagnosed ALL from 2007 to 2017 at St. Jude Children's Research Hospital. We measured vitamin D, vitamin D binding protein, retinol binding protein as a surrogate for vitamin A, and immunoglobulin isotypes in serum obtained at ALL diagnosis, and we assessed the association between vitamin deficiencies or levels and infection-related complications during the 6-week induction phase using Cox regression models.<BR><B>RESULTS: </B>Among 378 evaluable participants, vitamin A and D deficiencies were common (43% and 17%, respectively). Vitamin D deficiency was associated with higher risks of febrile neutropenia (adjusted hazard ratio [aHR], 1.7; P = .0072), clinically documented infection (aHR, 1.73; P = .025), and likely bacterial infection (aHR, 1.86; P = .008). Conversely, vitamin A deficiency was associated solely with a lower risk of sepsis (aHR, 0.19; P = .027).<BR><B>CONCLUSIONS: </B>In this retrospective study, vitamin D deficiency was associated with an increased risk of common infection-related complications during induction therapy for ALL. Additional studies are warranted to evaluate whether vitamin D supplementation could mitigate this effect.