Childhood cancers – give Vitamin D loading dose if low

Can screening for low vitamin D levels prevent bone health complications in paediatric oncology patients?

Cancer Rep (Hoboken) . 2021 Oct 26;e1534. doi: 10.1002/cnr2.1534

Leonie Naeije 1, Mandy Pohlui de Silva 1, Paul Hofman 2

Loading Dose Age
150 000 IU 1-2 year
300 000 units 2-5 year
600 000 units >5 year

Background: No international standards include vitamin D levels at diagnosis or during treatment. It is included in the Children's Oncology Group long-term follow-up guidelines. However, bone health complications (like osteopenia and atraumatic fractures) can occur at diagnosis or during treatment as well.

Cases: In this small case series, we illustrate the complexity of bone health complications among our broad paediatric oncology population. If the vitamin D level is low we supplement the patient with one standard oral dose (150 000 units for 1-2 year olds, 300 000 units for 2-5 year olds and 600 000 units for >5 year olds). We do not adjust depending on diagnosis.

Conclusion: Because of the potentially negative outcomes on short, medium and long term, we recommend checking vitamin D levels on diagnosis for all newly diagnosed patients. It is a simple, low cost test and one dose of oral supplementation can easily treat the deficiency.

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