Vitamin D Status in Pediatric Patients with Newly Diagnosed Malignant Disease: Preliminary Results

Abstract

Objectives – Vitamin D (VD) has an impact on the immune system via vitamin D nuclear receptor (VDR) present in various types of immune cells. Its anti-angiogenic, pro-apoptotic, and anti-proliferative effect have been found as well. We investigated VD status of paediatric patients with malignant disease such as leukaemia, lymphoma, Langerhans cell histiocytosis, and solid malignant tumours.

Materials and Methods – In children with malignant disease from the case cohort, total 41, serum VD level was measured upon first admission to the hospital. They were subdivided into those with leukaemia / lymphoma and those with solid malignant tumours (body and central nervous system). Langerhans cell histiocytosis was included in leukaemia /lymphoma group. The optimal level for VD was recommended to be >75 nmol/L. The insufficiency was presented with levels of 25-OH VD between 50 and 75 nmol/L, while levels ≤50 nmol/L were recognized as deficiency. We further categorized deficiency as strong (30 – 49.9 nmol/L), significant (20 – 29.9 nmol/L) and extreme (<20 nmol/L).

Results – Only three patients had optimal level of VD. All others (92.8%) suffered from VD insufficiency 11 (26.8%) and various levels of deficiency: 10 (24.4%) from strong, 11 (26.8%) significant, and 6 (14.6%) from extreme.

Conclusions – The prevalence of VD insufficiency/deficiency in paediatric patients with malignant disease is very high especially in patients with solid malignant tumour. Such condition, regarding that VD insufficiency/deficiency can debilitate immune system may have a negative impact on these patients.