Gary L. Simmons, Roy Sabo, Rehan Qayyum, May Aziz, Erika Martin, Robyn J. Bernard, Manjari Sriparna, Cody McIntire, Elizabeth Krieger, Donald F. Brophy, Ramesh Natarajan, Alpha Fowler III, Catherine H. Roberts, Amir Toor
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引用次数: 0
摘要
导言：在一项 II 期临床试验中，造血干细胞移植后静脉注射维生素 C 以降低非复发死亡率（NRM）。 方法 晚期血液恶性肿瘤患者在造血干细胞移植后第 1-14 天分三次静脉注射维生素 C，每次 50 毫克/千克/天，之后口服 500 毫克，每次 6 个月。 结果 所有入组患者（55 人）在第 0 天均缺乏维生素 C，但随后均恢复到正常水平。与倾向评分匹配的历史对照组相比，维生素 C 接受者的非复发死亡率（NRM，11% 对 25%，P 值 = 0.07）呈下降趋势。结论 在接受异基因造血干细胞移植的患者中，补充维生素 C 是可行的，可降低 NRM 并提高总生存率。需要在大型统一患者队列中进行随机试验，以确认这种易于获得且价格低廉的疗法的效用。
Feasibility of intravenous vitamin C supplementation in allogeneic hematopoietic cell transplant recipients
Introduction
Intravenous vitamin C was administered following hematopoietic stem cell transplant to mitigate nonrelapse mortality (NRM) in a Phase II clinical trial.
Methods
Patients with advanced hematologic malignancies received IV vitamin C, 50 mg/kg/day, in three divided doses on days 1–14 after HSCT, followed by 500 mg bid oral until 6 months.
Results
All patients enrolled (55) were deficient in vitamin C at day 0 and had restoration to normal levels. Vitamin C recipients had a trend for lower nonrelapse mortality (NRM, 11% vs. 25%, p-value = 0.07) compared with propensity score-matched historical controls. A similar trend toward improved survival was observed (82% vs. 62% p = 0.06), with no attributable grade 3 and 4 toxicities to vitamin C.
Conclusion
In patients undergoing allogeneic HSCT, repletion of vitamin C is feasible and may reduce NRM and improve overall survival. Randomized trials in large uniform cohorts of patients are needed to confirm the utility of this easily available and inexpensive therapy.
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