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INTRAVENOUS VITAMIN C SUPPLEMENTATION IN ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANT RECIPIENTS: SALUTARY IMPACT ON CLINICAL OUTCOMES.
Simmons, Gary; Sabo, Roy; Aziz, May; Martin, Erika; Bernard, Robyn J; Sriparna, Manjari; McIntire, Cody; Krieger, Elizabeth; Brophy, Donald F; Natarajan, Ramesh; Fowler, Alpha; Roberts, Catherine H; Toor, Amir.
Afiliación
  • Simmons G; Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia.
  • Sabo R; Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia.
  • Aziz M; School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia.
  • Martin E; School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia.
  • Bernard RJ; School of Medicine, Virginia Commonwealth University, Richmond, Virginia.
  • Sriparna M; School of Medicine, Virginia Commonwealth University, Richmond, Virginia.
  • McIntire C; School of Medicine, Virginia Commonwealth University, Richmond, Virginia.
  • Krieger E; Department of Pediatrics, Virginia Commonwealth University, Richmond, Virginia.
  • Brophy DF; School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia.
  • Natarajan R; Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia.
  • Fowler A; Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia.
  • Roberts CH; Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia.
  • Toor A; Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia.
medRxiv ; 2023 Dec 25.
Article en En | MEDLINE | ID: mdl-37961224
Intravenous (IV) vitamin C improves organ function and reduces inflammation in sepsis, an inflammatory state like the post-hematopoietic stem cell transplant (SCT) milieu. The safety and efficacy of parenteral vitamin C after allogeneic hematopoietic stem cell transplant (HSCT) were evaluated in a phase I/II trial and clinical outcomes compared with a propensity score - matched historical control. Methods: Patients with advanced hematologic malignancies were enrolled in a phase 2 clinical trial, receiving IV vitamin C, 50mg/kg/d, divided into 3 doses given on days 1-14 after HSCT, followed by 500 mg bid oral from day 15 until 6 months post-SCT. Results: 55 patients received IV vitamin C: these include 10/10 HLA-MRD and MUD (n=48) and 9/10 HLA MUD recipients (n=7). All patients enrolled were deficient in vitamin C at day 0 and had restoration to normal levels for the remainder of the course. Vitamin C recipients had lower non-relapse mortality (11% vs. 25%, p-value = 0.07) and consequently, improved survival compared to historical controls (82% vs 62% p=0.06), with no attributable grade 3 and 4 toxicities to vitamin C. Patients with myeloid malignancies had improved survival (83% vs. 54%, p=0.02) and non-relapse mortality (NRM) (10% vs. 37%, p=0.009), as well as chronic GVHD, with similar relapse rates compared to controls. Conclusions: In patients undergoing allogeneic HSCT the administration of IV vitamin C is safe and reduces non-relapse mortality improving overall survival. Randomized trials are needed to confirm the utility of this easily available and inexpensive therapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: MedRxiv Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: MedRxiv Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos