Vitamin C and D supplementation may reduce AML treatment complications

Acute myeloid leukemia (AML) patients who took vitamin C and D supplements while undergoing intensive chemotherapy were less likely to become infected when compared to similarly treated patients who did not receive these supplements. , the incidence of complications such as bleeding and inflammation was low. Furthermore, although this study showed no difference in survival between the two groups, subgroup analysis showed that patients with a genetic mutation known as NPM1, which is found in approximately 3 to 3 patients with AML. The risk of death was shown to be nearly 50% lower among patients. Those who were taking supplements.The results were published in today’s journal Blood Advances.

To our knowledge, this is the first study to investigate the potential effects of vitamin C and D supplementation during intensive chemotherapy for AML. We have shown that taking the supplement is feasible and safe and may help reduce some of the serious adverse events associated with intensive chemotherapy, which is a clear benefit for patients. . ”

Dr. Christian Lesche, senior author of the study, Toulouse University Cancer Institute (France)

Based on the results of several previous studies, Dr. Reche and his colleagues began treatment with vitamin C and D supplements in all adult AML patients undergoing intensive chemotherapy. One of these studies suggested that higher vitamin D levels before donor stem cell transplantation reduced the risk of relapse after transplantation in AML patients, while two clinical studies suggested that vitamin C supplementation It has been shown that it may suppress the development of leukemia cells.

In this study, researchers compared the outcomes of 431 patients with AML who received intensive chemotherapy over five years at the Toulouse University Cancer Institute. 169 patients treated between 2018 and 2020 received vitamin C and D supplements, while 262 patients treated between 2015 and 2018 (control group) Vitamin C and D supplements were not administered. Add statements/information about responses that may include mitigation of side effects.

Patients in the supplement group had a median age of 65 years and 52% were women, compared to the control group, whose median age was 60 years and 53% were men. At the time of AML diagnosis, most patients in both groups had low levels of vitamin C and vitamin D. Approximately one-quarter of patients in the supplement group and one-third of patients in the control group received donor stem cell transplants. Median follow-up was 28.7 months in the supplement group and 58.2 months in the control group.

In the supplemented group, vitamin D levels significantly increased from 18 ng/mL at diagnosis to 39 ng/mL upon recovery from intensive chemotherapy. The normal range for vitamin D is 20 to 50 ng/mL. No significant increase in vitamin C levels was observed, probably due to the conservative regimen (6 grams per week).

During intensive chemotherapy, patients receiving the supplement were less likely to develop moderate to severe bacterial infections (27.2% vs. 35.1% of controls), bleeding (1.8% vs. 5.7% of controls), and potentially They were less likely to experience potentially life-threatening immune system inflammation. (1.8% vs. 8.8% in control). Median overall survival was 34.5 months, median recurrence-free survival was 20.6 months, and cumulative incidence of recurrence was 46.4%. When the researchers analyzed outcomes for all treated patients combined, no significant differences were observed between the two groups.

However, in a subgroup analysis, patients in the supplement group with the NPM1 mutation (the most common mutation found in 30-35% of AML patients) had a 48% lower risk of death compared to patients without the mutation. It turned out that there was. . Further research is needed to identify the mechanisms responsible for this difference in survival, Dr. Lesche said.

Dr. Récher and his team were particularly surprised by the improved survival of patients with NPM1 mutations who received the supplement, but cautioned that this association needs to be confirmed in larger randomized studies.

This study has some limitations. This was a retrospective, single-center study of all adult patients receiving intensive chemotherapy for AML, comparing outcomes for patients treated before and after the center introduced the supplement. This study also involved a relatively small number of patients. Additionally, all patients in the supplement group received both vitamin C and vitamin D, so the researchers were unable to analyze the independent effects of each vitamin or the value of combining them.

Despite these limitations, Dr. Reche said, “Our results encourage and support prospective clinical trials of vitamin C and D administration in patients with AML.”

As always, patients should check with their care team about any medications they are taking, including over-the-counter medications, vitamins, and dietary supplements, and should ask before starting certain supplements.