• Natalja Jackmann, Outi Mäkitie, Arja Harila-Saari, Jan Gustafsson, Dzeneta Nezirevic Dernroth, and Per Frisk.
• Department of Women's and Children's Health, University Children's Hospital, Uppsala, Sweden.
• Pediatr Blood Cancer. 2020 Apr 1; 67 (4): e28163.

BackgroundChildren and adolescents with leukemia are potentially at high risk of vitamin D inadequacy, which may have clinical relevance for skeletal morbidity, infections, and cancer outcome. This study aimed to evaluate vitamin D status at the time of diagnosis to investigate its predictors and association with overall survival in children with leukemia.ProcedureWe included all 295 children and adolescents diagnosed with leukemia at our institution between 1990 and 2016 who had available serum sample from the time of diagnosis. We analyzed serum 25-hydroxyvitamin D and parathyroid hormone levels and correlated them with clinical data.ResultsThe 25-hydroxyvitamin D level was deficient (< 25 nmol/L), insufficient (25-50 nmol/L), sufficient (50-75 nmol/L), and optimal (> 75 nmol/L) in 6.4%, 26.8%, 39.7%, and 27.1% of the children, respectively. Older age and a more recent time of sampling (calendar year) predicted lower 25-hydroxyvitamin D level. In preschool children (age ≤6 years), lower 25-hydroxyvitamin D level was also associated with acute myeloid leukemia, and a 25-hydroxyvitamin D level < 50 nmol/L was associated with inferior overall survival. In school-aged children (age > 6 years), the 25-hydroxyvitamin D level showed significant seasonal variation.ConclusionIt remains unclear whether vitamin D supplementation in pediatric leukemia patients will improve outcome.© 2020 Wiley Periodicals, Inc.

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