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. 2024 Aug 27;5(5):1043-1047.
doi: 10.1002/jha2.995. eCollection 2024 Oct.

Feasibility of intravenous vitamin C supplementation in allogeneic hematopoietic cell transplant recipients

Gary L Simmons  1 , Roy Sabo  2 , Rehan Qayyum  3 , May Aziz  4 , Erika Martin  4 , Robyn J Bernard  5 , Manjari Sriparna  5 , Cody McIntire  5 , Elizabeth Krieger  6 , Donald F Brophy  4 , Ramesh Natarajan  1 , Alpha Fowler Iii  1 , Catherine H Roberts  1 , Amir Toor  1   7
Affiliations

Feasibility of intravenous vitamin C supplementation in allogeneic hematopoietic cell transplant recipients

Gary L Simmons et al. EJHaem. .

Abstract

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.

Keywords: allogeneic stem cell transplantation; graft versus host disease; nonrelapse mortality; parenteral ascorbic acid.

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Conflict of interest statement

The authors have no conflict of interest to disclose.

Figures

FIGURE 1
FIGURE 1
(A) Cumulative incidence curves depicting NRM in the VC‐treated patient. (B) Multivariate model. (C) KM curves depicting improved survival in the VC‐treated patients (p = 0.057). (D) Multivariate model, only donor type and diagnosis were significant.
FIGURE 2
FIGURE 2
(A) Vitamin C levels in the entire cohort of patients. (B) CRP levels at the same time points.
See this image and copyright information in PMC

Update of

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