Is supplementation efficacious in maintaining adequate plasma levels of vitamin A and E for thalassemic patients undergoing hematopoietic stem cell transplantation? a cross-sectional study

ABSTRACT

Thalassemia along with hematopoietic stem cell transplantation [HSCT] can lead to major oxidative stress. Vitamins A and E are antioxidants which protect membrane from lipid peroxidation. We sought to determine for the first time, whether vitamins A and E supplementation is efficacious in maintaining or increasing plasma level of these vitamins in thalassemic children undergoing HSCT. A cross-sectional study was performed on 50 children with beta-thalassemia major hospitalized for HSCT. Patients took a daily multivitamin. Plasma vitamins A and E levels were measured at four different times on admission, HSCT day [day 0], day 7 and day 14 after HSCT. Plasma vitamin A and E were abnormal on admission in most patients [62.0% and 60.0% respectively]. Ratio of patient with normal to abnormal plasma level of the vitamins improved from baseline to a peak on day 7 then deteriorated afterward until day 14. There was an increasingly positive correlation between daily oral intake and plasma vitamin A at different times, but plasma vitamin E showed inverse correlation at first which tended towards no correlation subsequently. In multivariate analysis, supplementation significantly changed plasma level of vitamin A at different measurement time [P=0.001] within study subjects. But, plasma level of vitamin E showed no significant difference [P=0.2]. Our findings suggest that oral supplementation could have beneficial effects due to increasing plasma vitamin A level and preventing plasma vitamin E depletion