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Pediatric Transplants

Vitamin K deficiency in children pre-bone marrow transplantation

Bone Marrow Transplantation volume 37, pages 151–154 (2006)Cite this article

Abstract

This study examined the prevalence of vitamin K deficiency in children pre-bone marrow transplantation (BMT). Vitamin K status was measured by the PIVKA-II assay and prothrombin times. Blood samples were obtained before vitamin-containing TPN was infused. Results indicated that eight of 26 patients (31%) were vitamin K deficient; four cases were attributed to drug antagonism (phenytoin) and four were due to inadequate vitamin K intake, synthesis or malabsorption. Only one patient had a prolonged prothrombin time. Prothrombin time, in our study, is shown to be an ineffective screening tool to determine vitamin K status. All patients receiving phenytoin and chemotherapy are at increased risk of vitamin K deficiency.

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References

  1. Carlin A, Walker WA . Rapid development of vitamin K deficiency in an adolescent boy receiving total parenteral nutrition following bone marrow transplantation. Nutr Rev 1991; 49: 179–183.

    Article  CAS  Google Scholar 

  2. Shearer MJ, Williams A, Sen V, Schey SA . Vitamin K status of patients undergoing autologous bone marrow transplantation. Thromb Haemost 1991; 65: 1220 (abstract).

    Google Scholar 

  3. Carlin A, Davidson K, Sadowski J, O’Brien RS, Weinstein H, Lo C . Vitamin K levels and epoxide/vitamin K ratios in pediatric BMT patients receiving TPN. J Parenter Enteral Nutr 1992; 84 (abstract).

  4. Elston TN, Dudley JM, Shearer MJ, Schey SA . Vitamin K prophylaxis in high-dose chemotherapy. Lancet 1995; 345: 1245.

    Article  CAS  Google Scholar 

  5. Fainstein V, Bodley GP, McCredie KB, Keating MJ, Estey EH, Bolivar R et al. Coagulation abnormalities induced by β-lactam antibiotics in cancer patients. J Infect Dis 1983; 148: 745–750.

    Article  CAS  Google Scholar 

  6. Conly J, Suttie J, Reid E, Loftson J, Ramotar K, Louie T . Dietary deficiency of phylloquinone and reduced serum levels in febrile neutropenic cancer patients. Am J Clin Nutr 1989; 50: 109–113.

    Article  CAS  Google Scholar 

  7. Jones PG, Strother SV, Rolston KV, Fainstein V, Bodey GP . Hypoprothrombinemia in patients with cancer receiving cefoperazone and mezlocillin. Arch Intern Med 1986; 146: 1397–1399.

    Article  CAS  Google Scholar 

  8. Motohara K, Kuroki Y, Kan H, Endo F, Matsuda I . Detection of vitamin K deficiency by use of an enzyme-linked immunosorbent assay for circulating abnormal prothrombin. Pediatr Res 1985; 19: 354–357.

    Article  CAS  Google Scholar 

  9. Quick AJ . Hemorrhagic Diseases and Thrombosis, 2nd edn. Lea & Febiger: Philadelphia, 1966.

    Google Scholar 

  10. Andreasen PB, Lyngbye J, Trolle E . Abnormalities in liver function tests during long-term diphenylhydantoin therapy in epileptic out-patients. Acta Med Scand 1973; 194: 261–264.

    Article  CAS  Google Scholar 

  11. Mountain KR, Hirsh J, Gallus AS . Neonatal coagulation defect due to anticonvulsant drug treatment in pregnancy. Lancet 1970; 1: 265–268.

    Article  CAS  Google Scholar 

  12. Davies VA, Rothberg AD, Argent AC, Atkinson PM, Staub H, Pienaar NL . Precursor prothrombin status in patients receiving anticonvulsant drugs. Lancet 1985; 1: 126–128.

    Article  CAS  Google Scholar 

  13. Tam DA, Myer EC . Vitamin K-dependent coagulopathy in a child receiving anticonvulsant therapy. J Child Neurol 1996; 11: 244–246.

    Article  Google Scholar 

  14. Rickard KA, Grosfeld JL, Coates TD, Weetman R, Baehner RL . Advances in nutrition care of children with neoplastic disease: a review of treatment, research, and application. J Am Diet Assoc 1986; 86: 1666–1676.

    CAS  PubMed  Google Scholar 

  15. Kaufman PA, Jones RB, Greenberg CS, Peters WP . Autologous bone marrow transplantation and factor XII, factor VII, and protein C deficiencies. Cancer 1990; 66: 515–521.

    Article  CAS  Google Scholar 

  16. Scrobohaci ML, Drouet L, Monem-Mansi A, Devergie A, Baudin B, D’Agay MF et al. Liver veno-occlusive disease after bone marrow transplantation, changes in coagulation parameters and endothelial markers. Thromb Res 1991; 63: 509–519.

    Article  CAS  Google Scholar 

  17. Pihusch R, Salat C, Schmidt E, Gohring P, Pihusch M, Hiller E et al. Hemostatic complications in bone marrow transplantation: a retrospective analysis of 447 patients. Transplantation 2002; 74: 1303–1309.

    Article  Google Scholar 

  18. Schneider DT, Cho J, Laws HJ, Dilloo D, Gobel U, Nurnberger W . Serial evaluation of the oncological pediatric risk of mortality (O-PRISM) score following allogeneic bone marrow transplantation in children. Bone Marrow Transplant 2002; 29: 383–389.

    Article  CAS  Google Scholar 

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Acknowledgements

We acknowledge the ongoing support of Dr Fred Saunders, Dr Melvin Freedman and the nurses at the BMT unit. This study was generously supported by a grant from the Canadian Foundation for Dietetic Research.

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Authors and Affiliations

  1. Division of Haematology/Oncology, Department of Clinical Dietetics, The Hospital for Sick Children, Toronto, Ontario, Canada

    M A Barron

  2. Division of Haematology/Oncology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada

    J Doyle

  3. Division of Gastroenterology and Nutrition, Departments of Paediatrics and Nutritional Sciences, Program in Metabolism, Research Institute, HSC, Centre for International Health, The Hospital for Sick Children, University of Toronto, Toronto, Canada

    S Zlotkin

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  1. M A Barron
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  2. J Doyle
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  3. S Zlotkin
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Correspondence to M A Barron.

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Barron, M., Doyle, J. & Zlotkin, S. Vitamin K deficiency in children pre-bone marrow transplantation. Bone Marrow Transplant 37, 151–154 (2006). https://doi.org/10.1038/sj.bmt.1705215

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