Overall survival did not differ, but significant interaction found between supplementation and NPM1 with survival
By Elana Gotkine HealthDay Reporter
WEDNESDAY, Sept. 6, 2023 (HealthDay News) — For patients with acute myeloid leukemia (AML), supplementation with vitamins C and D during chemotherapy may improve outcomes but may not improve overall survival (OS), according to a study published online Sept. 6 in Blood Advances.
Pierre Luc Mouchel, M.D., from the Centre Hospitalier Universitaire de Toulouse in France, and colleagues compared the outcomes of patients treated before and after the practice change of adding vitamins C and D to the supportive care of AML patients in 2018. A total of 431 patients were included from 2015 to 2020: 262 and 169 received no supplementation and supplementation, respectively. Vitamins C and D were administered from day 10 of chemotherapy until hematologic recovery from induction and consolidation.
The researchers found that in the supplementation group, vitamin D levels increased significantly upon recovery from induction compared with diagnosis, and pretransplant levels were significantly higher in the supplementation group versus the control group (median, 33 versus 19 ng/mL). The rates of bacterial or fungal infection, hemorrhage, or macrophage activation syndrome were lower in the supplementation group during induction, while no difference was seen in response rate, relapse incidence, or OS. There was a significant interaction between vitamin C/D and NPM1 mutation in a multivariate analysis for OS, indicating better OS with supplementation among patients with NPM1 mutations (hazard ratio [HR], 0.52; 95 percent confidence interval [CI], 0.30 to 0.90) versus wild-type NPM1 patients (HR, 1.01; 95 percent CI, 0.68 to 1.51).
“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,” coauthor Christian Récher, M.D., of the University Cancer Institute of Toulouse, said in a statement.
Several authors disclosed ties to the pharmaceutical industry.
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