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

Abstract

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