The Effect Of Vitamin D Deficiency In Child With Thalassemia Major After Hematopoietic Stem Cell Transplantation

Objective:Vitamin D is involved in the proliferation and differentiation of various immune cells in human body,and the level of vitamin D has a certain influence on the outcome of hematopoietic stem cell transplantation.In this study,the serum levels of 25 hydroxyvitamin D3 were measured in 64 children with severe thalassemia,and the effects of insufficient vitamin D levels on the outcome of hematopoietic stem cell transplantation were analyzed,so as to provide reference for the prevention of adverse events after hematopoietic stem cell transplantation and the improvement of the survival of children with thalassemia after transplantation.Methods:In this experiment,between August 1,2018 and October 18,2020,A total of 64 children with thalassemia major who underwent hematopoietic stem cell transplantation in the Department of Hematology,Zhongshan Hospital Affiliated to Xiamen University were examined and 40 cases in Xiamen The Department of Pediatrics of Zhongshan Hospital affiliated to the University performed a health check on children’s 25-hydroxyvitamin D levels.The 25-hydroxyvitamin D levels measured in children with the disease were divided into two groups with 50 nmol/1 as the limit:<50nmol/l(deficient group)and≥50nmol/l(non-deficient group),and compared the two with SPSS data statistical analysis software Group implantation status after transplantation,serious bacterial and fungal infection,EMV infection,CMV infection,severe oral mucositis,central nervous system injury,thrombotic-related diseases,OS,incidence and severity of acute and chronic GVHD,and other complications Whether there is a relationship and difference between them,and compare whether there is a difference in the incidence of vitamin D deficiency between healthy children and thalassemia children.Results:A total of 64 cases transplanted children were included in the study.Patient follow-up will end on January 20,2021,Among them,no children were followed up and data were missing.The median follow-up time was 19 months(100 days to 31 months).The average serum 25-hydroxyvitamin D level of all children before transplantation was 60.32±19.75 nmol/l.There were 27 cases(42.19%)of 25hydroxyvitamin D deficiency.The overall survival rate and the thalassaemia-free survival rate were 96.87%and 100%respectively,In total,There were 2 deaths.the transplant-related mortality rate was 3.13%,The OS of the vitamin D non-deficiency group and the vitamin D insufficient group were 100%and 92.59%.Comparing the two groups in terms of hematopoietic reconstitution time,poor implantation/failure,fungal and bacterial infection,CMV infection,severe oral mucositis,OS,etc.p>0.05,no significant difference,after transplantation aGVHD,severe aGVHD,cGVHD,EBV infection,etc.p<0.05,there is a significant difference.The study also included 40 healthy children,Among them,8 healthy children(20.00%)with 25-hydroxyvitamin D deficiency;27 cases(42.19%)with 25-hydroxyvitamin D deficiency in the children group,p<0.05,the difference was statistically significant.Conclusion:(1)The incidence of 25-hydroxyvitamin D deficiency in children with thalassemia is significantly higher than that in healthy children,with statistical significance.(2)Compared with the 25-hydroxyvitamin D level non-deficient group,The incidence of aGVHD、Severe aGVHD、cGVHD and EBV infection in children with thalassemia in the 25-hydroxyvitamin D deficiency group was significantly increased after hematopoietic stem cell transplantation.(3)The 25hydroxyvitamin D level had no effect on implantation rate and overall survival rate in children with thalassemia after HSCT.(4)The 25-hydroxyvitamin D has no significant statistical significance for the infection of bacteria,fungi after hematopoietic stem cell transplantation in children with thalassemia.