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1.
Cancer Med ; 10(13): 4177-4194, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34100559

RESUMEN

BACKGROUND: Prevalent vitamin D deficiency (VDD) and low bone mineral density (BMD) have led to vitamin D supplementation for children with cancer, regardless vitamin D status. However, it remains unsettled whether this enhances bone strength. We sought to address this issue by carrying out a systematic review of the literature. METHODS: We conducted a literature search using PubMed, Embase, and Cochrane databases. Studies including children up to 5 years after cancer therapy were assessed for the association between 25-hydroxyvitamin D (25OHD) levels and BMD Z-scores or fractures, and the effect of vitamin D supplementation on BMD or fractures. Evidence quality was assessed using the GRADE methodology. RESULTS: Nineteen studies (16 observational and 3 interventional, mainly involving children with hematologic malignancies) were included. One study which analyzed 25OHD as a threshold variable (≤10 ng/ml) found a significant association between 25OHD levels and BMD Z-scores, while 25OHD as a continuous variable was not significantly associated with BMD Z-scores in 14 observational studies. We found neither a significant association between lower 25OHD levels and fractures (2 studies), nor between vitamin D (and calcium) supplementation and BMD or fracture frequency (3 studies) (very low quality evidence). CONCLUSION: There is a lack of evidence for an effect of vitamin D (and calcium) supplementation on BMD or fractures in children with cancer. Further research is needed; until then, we recommend dietary vitamin D/calcium intake in keeping with standard national guidelines, and periodic 25OHD monitoring to detect levels <20 ng/ml. Vitamin D/calcium supplementation is recommended in children with low levels, to maintain levels ≥20 ng/ml year-long.


Asunto(s)
Densidad Ósea , Fracturas Óseas/prevención & control , Neoplasias Hematológicas , Neoplasias , Deficiencia de Vitamina D/terapia , Vitamina D/análogos & derivados , Vitaminas/administración & dosificación , Adolescente , Calcio de la Dieta/administración & dosificación , Supervivientes de Cáncer , Niño , Preescolar , Consenso , Fracturas Óseas/sangre , Fracturas Óseas/etiología , Neoplasias Hematológicas/sangre , Neoplasias Hematológicas/complicaciones , Neoplasias Hematológicas/terapia , Humanos , Neoplasias/sangre , Neoplasias/complicaciones , Neoplasias/terapia , Estudios Observacionales como Asunto , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangre , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Ensayos Clínicos Controlados Aleatorios como Asunto , Vitamina D/administración & dosificación , Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones
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