Discussion
bone loss post-aHSCT, bone loss
BONE LOSS
To the best of our knowledge, this study is the first randomized controlled trial investigating the effectiveness of a loading dose vit D (100,000 IU) in improving post-aHSCT 25 (OH) D levels in adult aHSCT recipients. Our findings provide important information on vit D supplementation regimens for this population who are at high risk of vit D deficiency.The prevalence of vitD insufficiency in our study cohort is similar to previous reports demonstrating insufficient vit D before transplant [Patients with baseline insufficient vit DA positive correlation between low post-transplant 25(OH) D and low BMD was previously demonstrated [It has been reported that bone loss was greatest in the first 6 months post-transplant [There is increasing interest in the immunomodulatory effects of vit D in the context of aHSCT [In summary, this study showed for the first time that administration of a single loading dose vit D was safe and well-tolerated in adult aHSCT recipients, and resulted in significantly higher vit D levels at day 30 post-transplant, compared with the control who received standard vit D supplementation. The benefit was most apparent among patients with vit D insufficiency at pre-transplant baseline who had significantly greater increases at both day 30 and day 100 post-aHSCT. Therefore, measuring pre-transplant vit D is recommended, and aggressive vit D supplementation for patients with low baseline vit D may prevent post-aHSCT vit D insufficiency. Future investigations with frequent vit D measures early post-transplant may offer valuable insights regarding loading dose vit D either pre-transplant or early post-transplant. In addition, longer-term prospective studies may help to shed light on the role of vit D supplementation in preventing bone loss post-aHSCT.