Vitamin C/D Supplements Decrease Complications in Patients with AML

Patients with acute myeloid leukemia (AML) who received vitamin C and D supplements while receiving chemotherapy experienced lower complication rates, such as infections, bleeding and inflammation when compared to patients who hadn’t received the supplements, according to recent research.

The study showed no difference when it came to overall survival (OS) rates, but within a subgroup analysis, there was a 50% lower risk of death in patients who received the supplements who had a genetic mutation called NPM1, which is found within one in three patients with AML, according to results published in the journal, Blood Advances.

“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. 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,” explained Dr. Christian Récher, of the University Cancer Institute of Toulouse in France and the study’s senior author.

Based on findings from prior studies — one that revealed that elevating vitamin D levels reduced the risk of a post-transplant relapse, while two others suggested that vitamin C supplements may reduce the risk of leukemic cells within the body — the study authors incorporated vitamin C and D supplements into treatment for patients with AML who were already receiving chemotherapy.

Four hundred thirty-one patients were evaluated in this study, all of which received intensive chemotherapy within a five-year period at the University Cancer Institute of Toulouse. The group of patients who received treatment between years 2018 and 2020 received vitamin C and D supplements, while the other half of the group who received treatment between 2015 and 2018 didn’t receive the supplements.

The average age was 65 and 52% were women in the supplementation group, while the other group’s average age was 60, with 53% of the patients being men. Most patients had low levels of vitamin C and D before beginning the study. A quarter of patients in the supplementation group received donor stem cell transplants, while a third of the control group had.

Vitamin D levels increased from 18 ng/mL to 39 ng/mL within the supplementation group, but no increase was seen in the control group. During chemotherapy, patients in the supplementation group experienced lowered risk of bacterial infections, bleeding and inflammation of the immune system.

The overall survival among the entire study population was 34.5 months, and both groups experience similar outcomes of survival with no significant difference between the two.

Among patients with an NPM1 mutation, there was a 48% reduced risk of death in comparison to individuals who did not have NPM1-mutant disease, according to the press release.

“Further studies are needed to identify the mechanism responsible for this survival difference,” explained Récher, who pointed out that more researched needs to be evaluated in a larger, randomized study to investigate improved survival in patients with NPM1.

Within the study, many limitations were involed. The study was created in one institution that focused on patients with AML that underwent chemotherapy, half being given vitamin C and D supplements. The evaluation pool was also quite small, and while both vitamins were given, it was hard to individually detect the impact of both.

“Despite these limitations. Our results are encouraging and support prospective clinical trials of vitamin C and D administration in AML patients,” Récher said.

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