Vitamin E and acute graft-versus-host disease after myeloablative allogeneic hematopoietic cell transplantation

4 Citations (Scopus)


OBJECTIVES: Vitamin E has antioxidant and immunomodulatory effects that might influence the development of acute graft-versus-host disease (GvHD). We investigated the association between plasma vitamin E levels and acute GvHD.

METHODS: We studied 115 adults who underwent myeloablative allogeneic hematopoietic cell transplantation between July 2015 and August 2018. Vitamin E was measured by high-performance liquid chromatography in stored plasma samples obtained pre-transplantation at day -23 (±15 days) and post-transplantation at day +28 (±3 days).

RESULTS: Pre-transplantation vitamin E levels were inversely associated with grade II-IV acute GvHD (hazard ratio 0.68 per 10 µmol/L increase, 95% confidence interval [CI]: 0.47-0.98). The association remained after adjustment for known prognostic factors for acute GvHD. Patients with levels below the median had a cumulative incidence of grade II-IV acute GvHD of 46% (CI: 33-59%) versus 21% (CI: 10-32%) in patients with levels above the median. No clear association with non-relapse mortality, relapse, or chronic GvHD was found. Post-transplantation vitamin E levels (measured in 72 [63%] patients) were correlated with pre-transplantation levels (ρ = .31) but were not associated with subsequent grade II-IV acute GvHD.

CONCLUSIONS: High pre-transplantation vitamin E levels were associated with less acute GvHD.

Original languageEnglish
JournalEuropean Journal of Haematology
Issue number3
Pages (from-to)417-424
Number of pages8
Publication statusPublished - Mar 2021


  • acute graft&#8208
  • versus&#8208
  • host disease
  • allogeneic hematopoietic cell transplantation
  • vitamin E
  • acute graft-versus-host disease


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