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The association between vitamin C and vitamin E supplement use before hematopoietic stem cell transplant and outcomes to two years

  • Barbara Bruemmer
    Affiliations
    B. Bruemmer is a lecturer, Department of Epidemiology, in the Nutritional Sciences Program, R. E. Patterson is a research associate professor in the Department of Epidemiology, and C. Cheney was an assistant professor in the Nutritional Sciences Program, University of Washington, Seattle. S. N. Aker is manager, Nutrition and Patient Food Services, and R. P. Witherspoon is medical director of the Transplant Clinic at the Seattle Cancer Care Alliance, Seattle, WA.
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  • Ruth E. Patterson
    Affiliations
    B. Bruemmer is a lecturer, Department of Epidemiology, in the Nutritional Sciences Program, R. E. Patterson is a research associate professor in the Department of Epidemiology, and C. Cheney was an assistant professor in the Nutritional Sciences Program, University of Washington, Seattle. S. N. Aker is manager, Nutrition and Patient Food Services, and R. P. Witherspoon is medical director of the Transplant Clinic at the Seattle Cancer Care Alliance, Seattle, WA.
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  • Carrie Cheney
    Affiliations
    B. Bruemmer is a lecturer, Department of Epidemiology, in the Nutritional Sciences Program, R. E. Patterson is a research associate professor in the Department of Epidemiology, and C. Cheney was an assistant professor in the Nutritional Sciences Program, University of Washington, Seattle. S. N. Aker is manager, Nutrition and Patient Food Services, and R. P. Witherspoon is medical director of the Transplant Clinic at the Seattle Cancer Care Alliance, Seattle, WA.
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  • Saundra N. Aker
    Affiliations
    B. Bruemmer is a lecturer, Department of Epidemiology, in the Nutritional Sciences Program, R. E. Patterson is a research associate professor in the Department of Epidemiology, and C. Cheney was an assistant professor in the Nutritional Sciences Program, University of Washington, Seattle. S. N. Aker is manager, Nutrition and Patient Food Services, and R. P. Witherspoon is medical director of the Transplant Clinic at the Seattle Cancer Care Alliance, Seattle, WA.
    Search for articles by this author
  • Robert P. Witherspoon
    Affiliations
    B. Bruemmer is a lecturer, Department of Epidemiology, in the Nutritional Sciences Program, R. E. Patterson is a research associate professor in the Department of Epidemiology, and C. Cheney was an assistant professor in the Nutritional Sciences Program, University of Washington, Seattle. S. N. Aker is manager, Nutrition and Patient Food Services, and R. P. Witherspoon is medical director of the Transplant Clinic at the Seattle Cancer Care Alliance, Seattle, WA.
    Search for articles by this author

      Abstract

      Objective To examine the prevalence of supplement use in persons before receiving hematopoietic stem cell transplant (HSCT) and the association of select supplements with outcomes. Design This observational cohort study included a questionnaire on supplement use before HSCT. Nonrelapse mortality, recurrence/relapse, and mortality or relapse (the inverse of disease-free survival) were followed to two years. Subjects/Setting Persons receiving HSCT at the Fred Hutchinson Cancer Research Center between September 1994 and December 1997 were eligible (N=1,182). Statistical Analyses Performed Descriptive statistics and univariate and Cox regression analyses were conducted. Results Sixty-six percent of patients used supplements (31% vitamin C, 19% vitamin E, and 20% herbs or others preparations). Vitamin C at ≥500 mg/day was inversely associated with recurrence among persons with breast cancer (RR=0.11; 95% CI, 0.02-0.89; P=.03). However, among persons with acute leukemia, vitamin C at ≥500 mg/day was positively associated with nonrelapse mortality (RR=2.25; 95% CI, 1.33-3.83; P=.01) and mortality or relapse (RR=1.63; 95% CI, 1.09-2.44; P=.01), respectively. Vitamin E at ≥400 IU/day was positively associated with mortality or relapse (RR=1.77; 95% CI, 1.06 −2.96; P=.02). Applications/Conclusions Though this work was observational, the results suggest supplemental vitamin C before therapy may be beneficial in persons with breast cancer but both vitamin C and vitamin E may increase risk in persons with acute leukemia receiving HSCT. Practitioners should document supplement use in subjects receiving therapy for cancer. J Am Diet Assoc. 2003;103:982-990.
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