Oral Supplements Can Improve Vitamin C Deficiency in Myeloid Malignancies

By Andrew Moreno - Last Updated: August 23, 2024

Vitamin C deficiency in patients who have low-risk myeloid malignancies or precursor conditions can be improved with oral supplementation. This is according to phase II study findings presented at the European Hematology Association 2024 Hybrid Congress in Madrid, Spain.

Advertisement

The randomized, placebo-controlled EVI-2 study set out to explore use of oral vitamin C supplementation in management of myeloid malignancies and the precursor condition, clonal cytopenia of undetermined significance.

The study cohort was 109 patients with low-risk myeloid malignancies or precursor conditions, with 57% of this cohort having inadequate peripheral blood plasma vitamin C concentration at baseline. From this cohort, 54 patients received placebo, and 55 patients received oral vitamin C administered at 1,000 mg daily for 12 months. The placebo group had a median age of 75 years and was 78% male, and the vitamin C group had a median age of 72.3 years and was 65% male.

In the vitamin C group, the investigators observed a significant increase in median vitamin C plasma concentration of 45.85 μmol per liter at baseline to 81.90 μmol per liter at 12 months (P<1×10-7). The placebo group saw an increase from 43.75 μmol per liter at baseline to only 48.73 μmol per liter at 12 months (P=0.92).

Serious adverse events occurred in 27% of the vitamin C group and 43% of the placebo group. There were 35 mortalities in the study, 11 of which were in the vitamin C group and 24 in the placebo group.

Multivariable analysis conducted in the study found the oral vitamin C supplements were statistically significantly associated with longer overall survival (OS) compared with placebo. Median OS was not reached in the vitamin C group and was 42.2 months in the placebo group (Hazard ratio 2.88; P=0.0025).

“The significantly longer OS observed in the vitamin C group compared [with] the placebo group warrants further investigation in a sufficiently powered phase III study,” the study investigators concluded.

Reference

Mikkelsen SU, Vallentin A, Nielsen A, et al. Vitamin C supplementation in patients with clonal cytopenia of undetermined significance or low-risk myeloid malignancies: results from EVI-2, a randomized, placebo-controlled phase 2 study. Abstract #LB3444. Presented at the European Hematology Association 2024 Hybrid Congress; June 13-16, 2024; Madrid, Spain.

Post Tags:EHA 2024
Advertisement
Advertisement
Advertisement