INTRAVENOUS VITAMIN C SUPPLEMENTATION IN ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANT RECIPIENTS: SALUTARY IMPACT ON CLINICAL OUTCOMES.
| العنوان: | INTRAVENOUS VITAMIN C SUPPLEMENTATION IN ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANT RECIPIENTS: SALUTARY IMPACT ON CLINICAL OUTCOMES. |
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| المؤلفون: | Simmons G; Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia., Sabo R; Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia., Aziz M; School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia., Martin E; School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia., Bernard RJ; School of Medicine, Virginia Commonwealth University, Richmond, Virginia., Sriparna M; School of Medicine, Virginia Commonwealth University, Richmond, Virginia., McIntire C; School of Medicine, Virginia Commonwealth University, Richmond, Virginia., Krieger E; Department of Pediatrics, Virginia Commonwealth University, Richmond, Virginia., Brophy DF; School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia., Natarajan R; Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia., Fowler A 3rd; Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia., Roberts CH; Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia., Toor A; Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia.; Lehigh Valley Health Network, Allentown, Pennsylvania. |
| المصدر: | MedRxiv : the preprint server for health sciences [medRxiv] 2023 Dec 25. Date of Electronic Publication: 2023 Dec 25. |
| نوع المنشور: | Preprint |
| اللغة: | English |
| بيانات الدورية: | Country of Publication: United States NLM ID: 101767986 Publication Model: Electronic Cited Medium: Internet NLM ISO Abbreviation: medRxiv Subsets: PubMed not MEDLINE |
| مستخلص: | Intravenous (IV) vitamin C improves organ function and reduces inflammation in sepsis, an inflammatory state like the post-hematopoietic stem cell transplant (SCT) milieu. The safety and efficacy of parenteral vitamin C after allogeneic hematopoietic stem cell transplant (HSCT) were evaluated in a phase I/II trial and clinical outcomes compared with a propensity score - matched historical control. Methods: Patients with advanced hematologic malignancies were enrolled in a phase 2 clinical trial, receiving IV vitamin C, 50mg/kg/d, divided into 3 doses given on days 1-14 after HSCT, followed by 500 mg bid oral from day 15 until 6 months post-SCT. Results: 55 patients received IV vitamin C: these include 10/10 HLA-MRD and MUD (n=48) and 9/10 HLA MUD recipients (n=7). All patients enrolled were deficient in vitamin C at day 0 and had restoration to normal levels for the remainder of the course. Vitamin C recipients had lower non-relapse mortality (11% vs. 25%, p-value = 0.07) and consequently, improved survival compared to historical controls (82% vs 62% p=0.06), with no attributable grade 3 and 4 toxicities to vitamin C. Patients with myeloid malignancies had improved survival (83% vs. 54%, p=0.02) and non-relapse mortality (NRM) (10% vs. 37%, p=0.009), as well as chronic GVHD, with similar relapse rates compared to controls. Conclusions: In patients undergoing allogeneic HSCT the administration of IV vitamin C is safe and reduces non-relapse mortality improving overall survival. Randomized trials are needed to confirm the utility of this easily available and inexpensive therapy. |
| معلومات مُعتمدة: | P30 CA016059 United States CA NCI NIH HHS |
| فهرسة مساهمة: | Keywords: Graph analysis; Parenteral ascorbic acid; allogeneic stem cell transplantation; graft vs. host disease; non-relapse mortality |
| تواريخ الأحداث: | Date Created: 20231114 Latest Revision: 20240101 |
| رمز التحديث: | 20240101 |
| مُعرف محوري في PubMed: | PMC10635184 |
| DOI: | 10.1101/2023.10.24.23297165 |
| PMID: | 37961224 |
| قاعدة البيانات: | MEDLINE |
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