{Reference Type}: Journal Article
{Title}: Association of Vitamin A and D Deficiencies with Infectious Outcomes in Children Undergoing Intensive Induction Therapy for Acute Lymphoblastic Leukemia.
{Author}: Penkert RR;Jones BG;Tang L;Su Y;Jeha S;Yang J;Yang W;Ferrolino J;Strength R;Pui CH;Cross SJ;Hurwitz JL;Wolf J;
{Journal}: J Pediatr
{Volume}: 273
{Issue}: 0
{Year}: 2024 Jun 14
{Factor}: 6.314
{DOI}: 10.1016/j.jpeds.2024.114148
{Abstract}: <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.