Vitamin Supplementation During Treatment for Acute Myeloid Leukemia
Supplementation of vitamins C and D during treatment for acute myeloid leukemia (AML) is associated with a reduced rate of complications when compared with treatment alone, according to the results of a recent study.1 Further, vitamin supplementation was associated with better overall survival in patients with AML with NPM1 mutations.
Included in the retrospective study were 431 adults newly diagnosed with AML from January 2015 to May 2020. All participants were part of the Toulouse DATAML registry and were being treated with intensive chemotherapy. Patients with acute promyelocytic leukemia were excluded. Of the total patients, 169 patients received vitamin C and D supplementation during treatment and 262 patients did not. Vitamin supplementation was given from day 10 of chemotherapy until the patient achieved hematologic recovery from induction and consolidation.
The results indicated that vitamin D levels were significantly increased in the supplementation group when compared with levels at diagnosis. Additionally, levels prior to allogeneic hematopoietic cell transplantation were significantly higher in the supplementation group when compared with the control group.
The rate of bacterial or fungal infection, hemorrhage, and macrophage activation syndrome were lower in the supplementation group during induction. No difference was observed in response rate and relapse incidence.
Vitamin C and D supplementation was significantly and independently associated with better overall survival in patients with AML and NPM1 mutations (HR 0.52; 95% CI, 0.30-0.90; P = 0.019). However, this association was not observed in wild-type NPM1 (HR 1.01; 95% CI, 0.68-1.51; P = 0.95).
A notable limitation of the study was the concomitant use of vitamins C and D, meaning no associations were able to be made about supplementation of either vitamin independently.
“To the best of our knowledge, this is the first study to examine the potential effects of vitamin C and D supplementation during intensive chemotherapy for AML,” the senior author, Christian Récher, MD, concluded in a press release.2 “We have shown that supplementation is feasible and safe and may help reduce some significant adverse events associated with intensive chemotherapy, which is a clear benefit for patients.”
- Mouchel PL, Bérard E, Tavitian S, et al. Vitamin C and D supplementation in acute myeloid leukemia. Blood Adv. 2023;7(22):6886-6897. doi:10.1182/bloodadvances.2023010559.
- Patients with AML who received vitamin C/D supplementations had fewer complications, but no overall survival benefit seen. News release. American Society of Hematology; September 6, 2023. Accessed November 22, 2023. https://www.hematology.org/newsroom/press-releases/2023/patients-with-aml-who-received-vitamin-cd-supplements-had-fewer-complications