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G241 Vitamin D levels in children and adolescents with cancer
  1. JR Ryan1,
  2. A Shankar1,
  3. C Brain2,
  4. F Kagalwala1,
  5. J Say1
  1. 1Children and Young Persons Cancer Services, University College London Hospital, London, UK
  2. 2Children and Young Persons Endocrine Services, University College London Hospital, London, UK

Abstract

Aim To assess blood vitamin D levels at time of cancer diagnosis in children, to supplement vitamin D where necessary, and reassess levels after 6 months of treatment.

Methods Newly diagnosed children had vitamin D, calcium [Ca], phosphate [P04] and parathyroid hormone (PTH) levels checked. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D (25[OH]D) level of less than 50nmol/L, and vitamin D insufficiency was defined as a 25[OH]D level of between 50–75 nmol/L. Children with levels <50 nmol/L were given cholecalciferol (6000 units/day >10 years, 3000 units/day <10 years) while children with levels between 50–75 nmol/L received a lower dose (2000 units/day >10 years, 1000 units/day <10 years). Vitamin D levels were rechecked after 6 months in all patients.

Results Forty-four children (31 male, 13 female) aged between 4 to 19 years are the subjects of this report. Twenty-six children were Caucasian and 18 were of Asian/African ethnicity. Only 16% [n = 7] of children had normal Vitamin D levels at diagnosis. The remaining 84% had either severe deficiency [n = 28; 64%] or insufficiency [n = 9; 20%]. Mean vitamin D levels in Caucasian children were 54nmol/L compared to 35 nmol/L (p < 0.05) in African/Asian children. 50% [n = 13/26] of Caucasian children were considered vitamin D deficient vs. 78% [n = 14/18] of children of Asian or African ethnicity [p < 0.05]

There was no seasonal variation in the mean vitamin D levels; 44.6 nmol/L in Autumn/Winter vs. 47.8 nmol/L in Spring/Summer. Of those with vitamin D <50 nmol/L, 3 had serum PO4 <0.89 and high PTH levels. In 2 children, with vitamin D <75 nmol/L, Ca was <2.15 nmol/L. Of the six children who have had 6 months of vitamin D supplementation, levels have normalised in four children [5/7 required treatment doses], and improved but not normalised in two children. One child who had normal vitamin D level at diagnosis has become deficient at 6 months [vitamin D <50 nmol/L].

Conclusion The majority of our children were vitamin D deficient at diagnosis with significantly lower levels in African/Asian children. Derangement of PTH, calcium or phosphate was rare.

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