{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T16:24:21Z","timestamp":1773851061912,"version":"3.50.1"},"reference-count":119,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Vitamin D is a pleiotropic secosteroid with endocrine and intracrine actions that influence key phases of allogeneic hematopoietic stem cell transplantation. Epithelial barriers, antigen-presenting cells and effector lymphocytes express the vitamin D receptor and enzymes required for local activation, allowing circulating 25-hydroxyvitamin D to be converted into its active form and modulate immune interactions. During the peri-transplant period, sunlight deprivation, reduced intake, mucosal injury, cholestasis and corticosteroid exposure markedly reduce vitamin D levels at a time when antigen presentation and immune reconstitution occur. This review integrates mechanistic immunology with clinical observations and interventional data to outline strategies that prevent severe deficiency. It summarizes epidemiology before and after transplantation, associations with acute and chronic graft-versus-host disease, relapse, engraftment, infections, bone health and survival, and evaluates dosing approaches including pre-conditioning loading and reassessment at day thirty with escalation if needed. Absorption-savvy formulations such as oral thin-film and intramuscular cholecalciferol are considered when gastrointestinal function is compromised. Given the high prevalence of deficiency, biological plausibility, safety and low cost, a structured approach that includes screening, repletion and monitoring to achieve concentrations of at least thirty nanograms per milliliter by day thirty represents a pragmatic and low-risk component of supportive care pending definitive evidence.<\/jats:p>","DOI":"10.3390\/cancers18060972","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T16:20:14Z","timestamp":1773764414000},"page":"972","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vitamin D and Hemopoietic Stem Cell Transplantation: Clinical Guidance for GVHD Management and Post-Transplant Outcomes"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8804-2640","authenticated-orcid":false,"given":"Manlio","family":"Fazio","sequence":"first","affiliation":[{"name":"Division of Hematology, Department of Human Pathology in Adulthood and Childhood \u201cGaetano Barresi\u201d, University of Messina, Via Consolare Valeria, 98125 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Elisa","family":"Nasso","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Human Pathology in Adulthood and Childhood \u201cGaetano Barresi\u201d, University of Messina, Via Consolare Valeria, 98125 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastiano","family":"Gangemi","sequence":"additional","affiliation":[{"name":"Allergy and Clinical Immunology Unit, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adele","family":"Bottaro","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Human Pathology in Adulthood and Childhood \u201cGaetano Barresi\u201d, University of Messina, Via Consolare Valeria, 98125 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7524-0103","authenticated-orcid":false,"given":"Luca","family":"Gammeri","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Dental Science and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 98125 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7947-158X","authenticated-orcid":false,"given":"Fabio","family":"Stagno","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Human Pathology in Adulthood and Childhood \u201cGaetano Barresi\u201d, University of Messina, Via Consolare Valeria, 98125 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6156-8239","authenticated-orcid":false,"given":"Alessandro","family":"Allegra","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Human Pathology in Adulthood and Childhood \u201cGaetano Barresi\u201d, University of Messina, Via Consolare Valeria, 98125 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1007\/s00134-025-07865-6","article-title":"Contemporary review of critical illness following allogeneic hematopoietic stem cell transplant in adults","volume":"51","author":"Munshi","year":"2025","journal-title":"Intensive Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Brennan, T.V., Rendell, V.R., and Yang, Y. (2015). Innate Immune Activation by Tissue Injury and Cell Death in the Setting of Hematopoietic Stem Cell Transplantation. Front. Immunol., 6.","DOI":"10.3389\/fimmu.2015.00101"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1182\/blood.2019000952","article-title":"Cytokines and costimulation in acute graft-versus-host disease","volume":"136","author":"Hill","year":"2020","journal-title":"Blood"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Chun, R.F., Liu, P.T., Modlin, R.L., Adams, J.S., and Hewison, M. (2014). Impact of vitamin D on immune function: Lessons learned from genome-wide analysis. Front. Physiol., 5.","DOI":"10.3389\/fphys.2014.00151"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1210\/jc.2009-1773","article-title":"Update in Vitamin D","volume":"95","author":"Adams","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1158\/2326-6066.CIR-14-0161","article-title":"The Immunological Synapse","volume":"2","author":"Dustin","year":"2014","journal-title":"Cancer Immunol. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1002\/pbc.25370","article-title":"Bone loss and vitamin D deficiency in children undergoing hematopoietic cell transplantation","volume":"62","author":"Bechard","year":"2015","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Flamann, C., Peter, K., Kreutz, M., and Bruns, H. (2019). Regulation of the Immune Balance During Allogeneic Hematopoietic Stem Cell Transplantation by Vitamin D. Front. Immunol., 10.","DOI":"10.3389\/fimmu.2019.02586"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1007\/s40265-023-01875-8","article-title":"The Role of Vitamin D in Health and Disease: A Narrative Review on the Mechanisms Linking Vitamin D with Disease and the Effects of Supplementation","volume":"83","author":"Rebelos","year":"2023","journal-title":"Drugs"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Fraser, D.R. (2025). Perspective: Vitamin D Deficiency Relationship to Initiation of Diseases. Nutrients, 17.","DOI":"10.3390\/nu17172900"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.abb.2012.02.016","article-title":"Extrarenal expression of the 25-hydroxyvitamin D-1-hydroxylase","volume":"523","author":"Adams","year":"2012","journal-title":"Arch. Biochem. Biophys."},{"key":"ref_12","first-page":"e10405","article-title":"Vitamin D and Immune Regulation: Antibacterial, Antiviral, Anti-Inflammatory","volume":"5","author":"Bishop","year":"2020","journal-title":"J. Bone Miner. Res. Plus"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1210\/endrev\/bnae009","article-title":"Consensus Statement on Vitamin D Status Assessment and Supplementation: Whys, Whens, and Hows","volume":"45","author":"Giustina","year":"2024","journal-title":"Endocr. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"100032","DOI":"10.1016\/j.pharmr.2024.100032","article-title":"Vitamin D and its analogs in immune system regulation","volume":"77","author":"Artusa","year":"2025","journal-title":"Pharmacol. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1210\/clinem\/dgae290","article-title":"Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline","volume":"109","author":"Demay","year":"2024","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1126\/science.1123933","article-title":"Toll-Like Receptor Triggering of a Vitamin D-Mediated Human Antimicrobial Response","volume":"311","author":"Liu","year":"2006","journal-title":"Science"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2405","DOI":"10.4049\/jimmunol.164.5.2405","article-title":"1\u03b1,25-Dihydroxyvitamin D3 Inhibits Differentiation, Maturation, Activation, and Survival of Dendritic Cells Leading to Impaired Alloreactive T Cell Activation","volume":"164","author":"Penna","year":"2000","journal-title":"J. Immunol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2074","DOI":"10.4049\/jimmunol.0803345","article-title":"1,25-Dihydroxyvitamin D3 Is an Autonomous Regulator of the Transcriptional Changes Leading to a Tolerogenic Dendritic Cell Phenotype","volume":"182","author":"Keresztes","year":"2009","journal-title":"J. Immunol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1007\/s00223-019-00577-2","article-title":"Vitamin D, Autoimmune Disease and Rheumatoid Arthritis","volume":"106","author":"Harrison","year":"2020","journal-title":"Calcif. Tissue Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.4049\/jimmunol.179.3.1634","article-title":"Modulatory Effects of 1,25-Dihydroxyvitamin D3 on Human B Cell Differentiation","volume":"179","author":"Chen","year":"2007","journal-title":"J. Immunol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1096\/fj.04-3284com","article-title":"Human cathelicidin antimicrobial peptide (CAMP) gene is a direct target of the vitamin D receptor and is strongly up-regulated in myeloid cells by 1,25-dihydroxyvitamin D3","volume":"19","author":"Gombart","year":"2005","journal-title":"FASEB J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1093\/ajcn\/87.3.688","article-title":"Pharmacokinetics of a single, large dose of cholecalciferol","volume":"87","author":"Ilahi","year":"2008","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"4555","DOI":"10.1182\/bloodadvances.2023009855","article-title":"Optimized vitamin D repletion with oral thin film cholecalciferol in patients undergoing stem cell transplant","volume":"7","author":"Bartlett","year":"2023","journal-title":"Blood Adv."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1210\/clinem\/dgz212","article-title":"Safety of High-Dose Vitamin D Supplementation: Secondary Analysis of a Randomized Controlled Trial","volume":"105","author":"Billington","year":"2020","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s40520-020-01678-x","article-title":"Vitamin D supplementation: Upper limit for safety revisited?","volume":"33","author":"Rizzoli","year":"2021","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_26","first-page":"1","article-title":"1,25-Dihydroxyvitamin D3Promotes High Glucose-Induced M1 Macrophage Switching to M2 via the VDR-PPAR\u03b3Signaling Pathway","volume":"2015","author":"Zhang","year":"2015","journal-title":"BioMed Res. Int."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"881","DOI":"10.2310\/JIM.0b013e31821b8755","article-title":"Vitamin D and the Immune System","volume":"59","author":"Aranow","year":"2011","journal-title":"J. Investig. Med."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Sassi, F., Tamone, C., and D\u2019Amelio, P. (2018). Vitamin D: Nutrient, Hormone, and Immunomodulator. Nutrients, 10.","DOI":"10.3390\/nu10111656"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.isci.2019.06.026","article-title":"Vitamin D\/Vitamin D Receptor Signaling Is Required for Normal Development and Function of Group 3 Innate Lymphoid Cells in the Gut","volume":"17","author":"He","year":"2019","journal-title":"iScience"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.jaci.2017.01.045","article-title":"Vitamin D downregulates the IL-23 receptor pathway in human mucosal group 3 innate lymphoid cells","volume":"141","author":"Konya","year":"2018","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"979","DOI":"10.4254\/wjh.v9.i23.979","article-title":"Innate lymphoid cells in tissue homeostasis and diseases","volume":"9","author":"Ignacio","year":"2017","journal-title":"World J. Hepatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1111\/j.1744-313X.2008.00758.x","article-title":"Association of vitamin D receptor polymorphisms with the outcome of allogeneic haematopoietic stem cell transplantation","volume":"35","author":"Middleton","year":"2008","journal-title":"Int. J. Immunogenet."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.21873\/anticanres.11483","article-title":"Acute Graft Versus Host Disease: A Comprehensive Review","volume":"37","author":"NASSEREDDiNE","year":"2017","journal-title":"Anticancer Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1016\/S0140-6736(09)60237-3","article-title":"Graft-versus-host disease","volume":"373","author":"Ferrara","year":"2009","journal-title":"Lancet"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2565","DOI":"10.1056\/NEJMra1703472","article-title":"Pathophysiology of Chronic Graft-versus-Host Disease and Therapeutic Targets","volume":"377","author":"Zeiser","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1182\/blood.2023022735","article-title":"Chronic graft-versus-host disease: Unresolved complication or ancient history?","volume":"144","author":"Pidala","year":"2024","journal-title":"Blood"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"6954","DOI":"10.1182\/blood-2023-185648","article-title":"High Incidence of Vitamin D Deficiency Among Patients Undergoing Hematopoietic Stem Cell Transplant and a Single Ultra-High Dose Vitamin D Replacement","volume":"142","author":"Toemthong","year":"2023","journal-title":"Blood"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1016\/j.bbmt.2010.12.704","article-title":"Vitamin D Level after Allogeneic Hematopoietic Stem Cell Transplant","volume":"17","author":"Sproat","year":"2011","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/j.bbmt.2010.10.009","article-title":"25-Hydroxy Vitamin D Deficiency Following Pediatric Hematopoietic Stem Cell Transplant","volume":"17","author":"Duncan","year":"2011","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1016\/j.bbmt.2016.03.026","article-title":"Vitamin D Deficiency in Pediatric Hematopoietic Stem Cell Transplantation Patients Despite Both Standard and Aggressive Supplementation","volume":"22","author":"Wallace","year":"2016","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1038\/bmt.2012.177","article-title":"Low levels of 25-hydroxyvitamin D before allogeneic hematopoietic SCT correlate with the development of chronic GVHD","volume":"48","author":"Glotzbecker","year":"2012","journal-title":"Bone Marrow Transplant."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e144271","DOI":"10.5812\/ijcm-144271","article-title":"Association Between Serum Levels of Vitamin D and Biochemical Markers Among Hematopoietic Stem Cell Transplantation Candidates: A Cross-Sectional Study","volume":"17","author":"Zahedi","year":"2024","journal-title":"Int. J. Cancer Manag."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.clnesp.2023.11.004","article-title":"Variability of contribution of 1,25 (OH)2D3 (vitamin D) level to hematopoietic stem cell transplantation outcome","volume":"58","author":"Kamel","year":"2023","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.bbmt.2019.10.011","article-title":"Association between Vitamin D and Risk for Early and Late Post-Transplant Complications","volume":"26","author":"Bhandari","year":"2020","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2539","DOI":"10.1007\/s00216-024-05699-7","article-title":"Commutability assessment of new standard reference materials (SRMs) for determining serum total 25-hydroxyvitamin D using ligand binding and liquid chromatography\u2013tandem mass spectrometry (LC\u2013MS\/MS) assays","volume":"417","author":"Wise","year":"2025","journal-title":"Anal. Bioanal. Chem."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Bodea, J., Beebe, K., Campbell, C., Salzberg, D., Schwalbach, C., Miller, H., Adams, R., Mirea, L., Castillo, P., and Horn, B. (2022). Impact of Adequate Day 30 Post-Pediatric Hematopoietic Stem Cell Transplantation Vitamin D Level on Clinical Outcome: An Observational Cohort Study. Biol. Blood Marrow Transplant., 28.","DOI":"10.1016\/j.jtct.2022.05.032"},{"key":"ref_47","first-page":"1025","article-title":"Micronutrient requirements for stem cell transplantation patients > 100 days after transplant and during graft versus host disease: A systematic review","volume":"33","author":"Johnson","year":"2025","journal-title":"Support. Care Cancer"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Bai, N., Lee, K., Limvorapitak, W., Liu, E., Kendler, D., Broady, R., and White, J. (2023). Loading dose vitamin D3 improves vitamin D insufficiency in adults undergoing hematopoietic stem cell transplantation: A randomized controlled trial. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0284644"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1038\/bmt.2015.123","article-title":"Increased incidence of chronic GvHD and CMV disease in patients with vitamin D deficiency before allogeneic stem cell transplantation","volume":"50","author":"Blennow","year":"2015","journal-title":"Bone Marrow Transplant."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1182\/bloodadvances.2021004958","article-title":"Impact of vitamin D level at diagnosis and transplantation on the prognosis of hematological malignancy: A meta-analysis","volume":"6","author":"Ito","year":"2022","journal-title":"Blood Adv."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1016\/j.bbmt.2015.06.009","article-title":"Vitamin D Deficiency and Survival in Children after Hematopoietic Stem Cell Transplant","volume":"21","author":"Wallace","year":"2015","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Mancin, S., Cangelosi, G., Matteucci, S., Palomares, S.M., Parozzi, M., Sandri, E., Sguanci, M., and Piredda, M. (2024). The Role of Vitamin D in Hematopoietic Stem Cell Transplantation: Implications for Graft-versus-Host Disease\u2014A Narrative Review. Nutrients, 16.","DOI":"10.3390\/nu16172976"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"104054","DOI":"10.1016\/j.transci.2024.104054","article-title":"Is there a relationship between vitamin D levels and graft versus host disease?","volume":"64","author":"Yigenoglu","year":"2024","journal-title":"Transfus. Apher. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"3143","DOI":"10.1200\/JCO.2017.73.0085","article-title":"Pretransplant Vitamin D Deficiency Is Associated With Higher Relapse Rates in Patients Allografted for Myeloid Malignancies","volume":"35","author":"Radujkovic","year":"2017","journal-title":"J. Clin. Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/ejh.12818","article-title":"Vitamin D in hematological disorders and malignancies","volume":"98","author":"Kulling","year":"2016","journal-title":"Eur. J. Haematol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1007\/s40199-019-00306-y","article-title":"Oral calcitriol in hematopoietic recovery and survival after autologous stem cell transplantation: A randomized clinical trial","volume":"27","author":"Raoufinejad","year":"2019","journal-title":"DARU J. Pharm. Sci."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"White, J.H. (2022). Emerging Roles of Vitamin D-Induced Antimicrobial Peptides in Antiviral Innate Immunity. Nutrients, 14.","DOI":"10.3390\/nu14020284"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1093\/infdis\/jiu235","article-title":"Vitamin D Deficiency Promotes Epithelial Barrier Dysfunction and Intestinal Inflammation","volume":"210","author":"Assa","year":"2014","journal-title":"J. Infect. Dis."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e12988","DOI":"10.1111\/tid.12988","article-title":"Vitamin D deficiency and infection risk in kidney transplant recipients: A single-center cohort study","volume":"20","author":"Corbella","year":"2018","journal-title":"Transpl. Infect. Dis."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Ki, M.S., Kim, N.E., Woo, A., Kim, S.Y., Kim, Y.S., Kim, H.E., Lee, J.G., Paik, H.C., and Park, M.S. (2024). Post-Transplant Vitamin D Deficiency in Lung Transplant Recipients: Impact on Outcomes and Prognosis. Transpl. Int., 37.","DOI":"10.3389\/ti.2024.13313"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2597","DOI":"10.1007\/s00198-018-4669-4","article-title":"Bone management in hematologic stem cell transplant recipients","volume":"29","author":"Kendler","year":"2018","journal-title":"Osteoporos. Int."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"3635","DOI":"10.1182\/blood-2003-09-3081","article-title":"Bone loss following hematopoietic stem cell transplantation: A long-term follow-up","volume":"103","author":"Schulte","year":"2004","journal-title":"Blood"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"393\u2013398, 393\u2013398","DOI":"10.4103\/2230-8210.152785","article-title":"Changes in bone mineral density and bone turnover markers in patients undergoing hematopoietic stem cell transplant","volume":"19","author":"Garg","year":"2015","journal-title":"Indian J. Endocrinol. Metab."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1200\/JCO.2014.57.8195","article-title":"Increased Incidence of Fractures in Recipients of Hematopoietic Stem-Cell Transplantation","volume":"33","author":"Pundole","year":"2015","journal-title":"J. Clin. Oncol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1002\/phar.2443","article-title":"Long-term Follow-up of Hematopoietic Stem Cell Transplant Survivors: A Focus on Screening, Monitoring, and Therapeutics","volume":"40","author":"Saunders","year":"2020","journal-title":"Pharmacother. J. Hum. Pharmacol. Drug Ther."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Miglietta, F., Iamartino, L., Palmini, G., Giusti, F., Marini, F., Iantomasi, T., and Brandi, M.L. (2023). Endocrine sequelae of hematopoietic stem cell transplantation: Effects on mineral homeostasis and bone metabolism. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.1085315"},{"key":"ref_67","first-page":"1160","article-title":"Effects of physical exercise in patients undergoing haematopoietic stem cell transplantation: Systematic review and meta-analysis","volume":"33","year":"2025","journal-title":"Support. Care Cancer"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"3877","DOI":"10.1210\/jc.2004-2161","article-title":"Prevention of Bone Loss after Allogeneic Stem Cell Transplantation by Calcium, Vitamin D, and Sex Hormone Replacement with or without Pamidronate","volume":"90","author":"Kananen","year":"2005","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1038\/s41409-021-01294-x","article-title":"Stoss therapy is safe for treatment of vitamin D deficiency in pediatric patients undergoing HSCT","volume":"56","author":"Bodea","year":"2021","journal-title":"Bone Marrow Transplant."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"2060","DOI":"10.1038\/s41409-020-0904-7","article-title":"To D or not to D: Vitamin D in hematopoietic cell transplantation","volume":"55","author":"Hong","year":"2020","journal-title":"Bone Marrow Transplant."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Wylon, K., Drozdenko, G., Krannich, A., Heine, G., D\u00f6lle, S., and Worm, M. (2017). Pharmacokinetic Evaluation of a Single Intramuscular High Dose versus an Oral Long-Term Supplementation of Cholecalciferol. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0169620"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1007\/s00394-023-03124-w","article-title":"Long-term supplementation with 3200 to 4000 IU of vitamin D daily and adverse events: A systematic review and meta-analysis of randomized controlled trials","volume":"62","author":"Zittermann","year":"2023","journal-title":"Eur. J. Nutr."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1093\/ndt\/gfae293","article-title":"The role of nutritional vitamin D in chronic kidney disease\u2013mineral and bone disorder in children and adults with chronic kidney disease, on dialysis, and after kidney transplantation\u2014A European consensus statement","volume":"40","author":"Vervloet","year":"2025","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1038\/nri3212","article-title":"Advances in graft-versus-host disease biology and therapy","volume":"12","author":"Blazar","year":"2012","journal-title":"Nat. Rev. Immunol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.chembiol.2013.12.016","article-title":"Vitamin D Metabolism, Mechanism of Action, and Clinical Applications","volume":"21","author":"Bikle","year":"2014","journal-title":"Chem. Biol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1210\/jc.2011-0385","article-title":"Evaluation, Treatment, and Prevention of Vitamin D Deficiency: An Endocrine Society Clinical Practice Guideline","volume":"96","author":"Holick","year":"2011","journal-title":"Med. J. Clin. Endocrinol. Metab."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Bhandari, R., Aguayo-Hiraldo, P., Malvar, J., Cheng, K., Sacapano, A., Abdel-Azim, H., Chi, Y.-Y., Wallace, G., Asgharzadeh, S., and Jodele, S. (2021). Ultra-High Dose Vitamin D in Pediatric Hematopoietic Stem Cell Transplantation: A Nonrandomized Controlled Trial. Biol. Blood Marrow Transplant., 27.","DOI":"10.1016\/j.jtct.2021.08.030"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"e2250681","DOI":"10.1001\/jamanetworkopen.2022.50681","article-title":"Association of Body Weight With Response to Vitamin D Supplementation and Metabolism","volume":"6","author":"Tobias","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1186\/s12887-023-04113-y","article-title":"Determination of Optimal Vitamin D Dosage in Children with Cholestasis","volume":"23","author":"Chongthavornvasana","year":"2023","journal-title":"BMC Pediatr."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"2388","DOI":"10.3945\/jn.116.231480","article-title":"Daily Cholecalciferol Supplementation during Pregnancy Alters Markers of Regulatory Immunity, Inflammation, and Clinical Outcomes in a Randomized Controlled Trial","volume":"146","author":"Zerofsky","year":"2016","journal-title":"J. Nutr."},{"key":"ref_81","first-page":"109","article-title":"Impact of a Replacement Algorithm for Vitamin D Deficiency in Adult Hematopoietic Stem Cell Transplant Patients","volume":"10","author":"Kenny","year":"2019","journal-title":"J. Adv. Pract. Oncol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"4289","DOI":"10.4049\/jimmunol.0803736","article-title":"Vitamin D-Directed Rheostatic Regulation of Monocyte Antibacterial Responses","volume":"182","author":"Adams","year":"2009","journal-title":"J. Immunol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1182\/blood-2002-11-3521","article-title":"Regulation of 25-hydroxyvitamin D3-1\u03b1-hydroxylase and production of 1\u03b1,25-dihydroxyvitamin D3 by human dendritic cells","volume":"102","author":"Fritsche","year":"2003","journal-title":"Blood"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"104889","DOI":"10.1016\/j.biosystems.2023.104889","article-title":"Modeling the interaction between donor-derived regulatory T cells and effector T cells early after allogeneic hematopoietic stem cell transplantation","volume":"227\u2013228","author":"Nishiyama","year":"2023","journal-title":"Biosystems"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1038\/s41581-022-00600-0","article-title":"Activation and regulation of alloreactive T cell immunity in solid organ transplantation","volume":"18","author":"Duneton","year":"2022","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"4519","DOI":"10.1172\/JCI141334","article-title":"The unsettled science of nonrenal calcitriol production and its clinical relevance","volume":"130","author":"Pike","year":"2020","journal-title":"J. Clin. Investig."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"e18761429310703","DOI":"10.2174\/0118761429310703240823045808","article-title":"Mechanism, Potential, and Concerns of Immunotherapy for Hepatocellular Carcinoma and Liver Transplantation","volume":"17","author":"Sensi","year":"2024","journal-title":"Curr. Mol. Pharmacol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1007\/s12015-025-10914-8","article-title":"Mesenchymal Stromal Cells and Graft-versus-Host Disease: Preclinical and Clinical Studies","volume":"21","author":"Wang","year":"2025","journal-title":"Stem Cell Rev. Rep."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1007\/s10787-019-00683-5","article-title":"Human umbilical cord mesenchymal stem cells alleviate inflammatory bowel disease by inhibiting ERK phosphorylation in neutrophils","volume":"28","author":"Wang","year":"2020","journal-title":"Inflammopharmacology"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1038\/ejcn.2014.209","article-title":"The effect of a single, large bolus of vitamin D in healthy adults over the winter and following year: A randomized, double-blind, placebo-controlled trial","volume":"69","author":"Kearns","year":"2014","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"T\u00f3th, B.E., Tak\u00e1cs, I., K\u00e1d\u00e1r, K., Mirani, S., Vecserny\u00e9s, M., and Lakatos, P. (2024). Safety and Efficacy of Loading Doses of Vitamin D: Recommendations for Effective Repletion. Pharmaceuticals, 17.","DOI":"10.3390\/ph17121620"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"341","DOI":"10.4158\/EP13265.RA","article-title":"Large, Single-Dose, Oral Vitamin D Supplementation in Adult Populations: A Systematic Review","volume":"20","author":"Kearns","year":"2014","journal-title":"Endocr. Pract."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1038\/oby.2011.404","article-title":"Volumetric Dilution, Rather Than Sequestration Best Explains the Low Vitamin D Status of Obesity","volume":"20","author":"Drincic","year":"2012","journal-title":"Obesity"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1515\/dx-2024-0147","article-title":"Vitamin D assay and supplementation: Still debatable issues","volume":"12","author":"Plebani","year":"2024","journal-title":"Diagnosis"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1515\/cclm-2024-1032","article-title":"Measurement of 1,25-dihydroxyvitamin D in serum by LC-MS\/MS compared to immunoassay reveals inconsistent agreement in paediatric samples","volume":"63","author":"Tang","year":"2024","journal-title":"Clin. Chem. Lab. Med."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.metabol.2018.12.010","article-title":"Vitamin D supplementation in obesity and during weight loss: A review of randomized controlled trials","volume":"92","author":"Bassatne","year":"2019","journal-title":"Metabolism"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"815","DOI":"10.4103\/ijem.IJEM_577_16","article-title":"High-dose Vitamin D supplementation precipitating hypercalcemic crisis in granulomatous disorders","volume":"21","author":"Sarathi","year":"2017","journal-title":"Indian J. Endocrinol. Metab."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1111\/jpc.14497","article-title":"Safety and effectiveness of stoss therapy in children with vitamin D deficiency","volume":"56","author":"Tannous","year":"2019","journal-title":"J. Paediatr. Child Health"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.1007\/s10620-025-08913-3","article-title":"Daily Vitamin D3 Versus Stoss Vitamin D3 for Correction of 25OHD Deficiency in Children with Inflammatory Bowel Disease, a Randomised Controlled Trial","volume":"70","author":"Leach","year":"2025","journal-title":"Dig. Dis. Sci."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s40261-021-01113-7","article-title":"Comparative Bioavailability Study of a New Vitamin D3 Orodispersible Film Versus a Marketed Oral Solution in Healthy Volunteers","volume":"42","author":"Radicioni","year":"2022","journal-title":"Clin. Drug Investig."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1007\/s11657-023-01341-8","article-title":"Reducing the risk of denosumab-induced hypocalcemia in patients with advanced chronic kidney disease: A quality improvement initiative","volume":"18","author":"Kanagalingam","year":"2023","journal-title":"Arch. Osteoporos."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1038\/bmt.2013.158","article-title":"Patient education in allogeneic hematopoietic cell transplant: What patients wish they had known about quality of life","volume":"49","author":"Jim","year":"2013","journal-title":"Bone Marrow Transplant."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.ajt.2022.12.007","article-title":"Nonskeletal and skeletal effects of high doses versus low doses of vitamin D3 in renal transplant recipients: Results of the VITALE (VITamin D supplementation in renAL transplant recipients) study, a randomized clinical trial","volume":"23","author":"Courbebaisse","year":"2023","journal-title":"Am. J. Transplant."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.hemonc.2017.05.012","article-title":"Hematopoietic cell transplantation: Training challenges and potential opportunities through networking and integration of modern technologies to the practice setting","volume":"10","author":"Aljurf","year":"2017","journal-title":"Hematol. Stem Cell Ther."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1210\/jc.2011-2757","article-title":"Do Glucocorticosteroids Alter Vitamin D Status? A Systematic Review with Meta-Analyses of Observational Studies","volume":"97","author":"Davidson","year":"2012","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1784","DOI":"10.1016\/j.bbmt.2020.07.001","article-title":"Bone Health Management After Hematopoietic Cell Transplantation: An Expert Panel Opinion from the American Society for Transplantation and Cellular Therapy","volume":"26","author":"Bar","year":"2020","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"e28163","DOI":"10.1002\/pbc.28163","article-title":"Vitamin D status in children with leukemia, its predictors, and association with outcome","volume":"67","author":"Jackmann","year":"2020","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_108","doi-asserted-by":"crossref","unstructured":"Alexandru, A., Ivan, C.-S., Tanasescu, S., Oprisoni, L.A., Dragomir, T.-L., Varga, N.-I., Mateescu, D., Diaconu, M., Margan, M.-M., and Boeriu, E. (2024). Are Pediatric Cancer Patients a Risk Group for Vitamin D Deficiency? A Systematic Review. Cancers, 16.","DOI":"10.3390\/cancers16244201"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1920","DOI":"10.1016\/j.bbmt.2018.03.008","article-title":"Steroid Refractory Chronic Graft-Versus-Host Disease: Cost-Effectiveness Analysis","volume":"24","author":"Yalniz","year":"2018","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_110","doi-asserted-by":"crossref","unstructured":"Kim, N.V., McErlean, G., Yu, S., Kerridge, I., Greenwood, M., and Lourenco, R.D.A. (2025). Healthcare Resource Use and Costs of Allogeneic Hematopoietic Stem Cell Transplantation Complications: A Scoping Review. Curr. Oncol., 32.","DOI":"10.3390\/curroncol32050283"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"4616","DOI":"10.1158\/1078-0432.CCR-18-3875","article-title":"Vitamin D Modifies the Incidence of Graft-versus-Host Disease after Allogeneic Stem Cell Transplantation Depending on the Vitamin D Receptor (VDR) Polymorphisms","volume":"25","author":"Cuadrado","year":"2019","journal-title":"Clin. Cancer Res."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"3378","DOI":"10.1182\/bloodadvances.2021005847","article-title":"Posttransplant cyclophosphamide for prevention of graft-versus-host disease: Results of the prospective randomized HOVON-96 trial","volume":"6","author":"Broers","year":"2022","journal-title":"Blood Adv."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"e32085","DOI":"10.1002\/pbc.32085","article-title":"Abatacept Prevents Severe Acute Graft-Versus-Host Disease Without Increasing Graft Failure Risk in Pediatric Bone Marrow Failure Syndromes","volume":"72","author":"Hudda","year":"2025","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_114","doi-asserted-by":"crossref","unstructured":"Iqbal, M., Nieto, F.A.M., Brannick, K.M., Li, Z., Murthy, H., Foran, J., Roy, V., Kharfan-Dabaja, M.A., and Ayala, E. (2023). A Calcineurin Inhibitor Free Graft Versus Host Disease Prophylaxis for Patients Undergoing Matched Related and Matched Unrelated Donor Allogeneic Hematopoietic Cell Transplant. Biol. Blood Marrow Transplant., 29.","DOI":"10.1016\/j.jtct.2023.02.001"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.1017\/S0007114522000149","article-title":"Sex differences in vitamin D metabolism, serum levels and action","volume":"128","author":"Wierzbicka","year":"2022","journal-title":"Br. J. Nutr."},{"key":"ref_116","doi-asserted-by":"crossref","unstructured":"Weich, L., Brummer, C., Ghimire, S., Peter, K., Althammer, M., Babl, N., Voll, F., Bruss, C., Hoering, M., and Wallner, S. (2025). Impact of Liver and Kidney Function on Vitamin D3 Metabolism in Female and Male Patients Undergoing Allogeneic Hematopoietic Stem-Cell Transplantation. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26072866"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s13293-021-00358-3","article-title":"The role of vitamin D in autoimmune diseases: Could sex make the difference?","volume":"12","author":"Dupuis","year":"2021","journal-title":"Biol. Sex Differ."},{"key":"ref_118","doi-asserted-by":"crossref","unstructured":"Caserta, S., Gangemi, S., Murdaca, G., and Allegra, A. (2023). Gender Differences and miRNAs Expression in Cancer: Implications on Prognosis and Susceptibility. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241411544"},{"key":"ref_119","doi-asserted-by":"crossref","unstructured":"Allegra, A., Caserta, S., Genovese, S., Pioggia, G., and Gangemi, S. (2023). Gender Differences in Oxidative Stress in Relation to Cancer Susceptibility and Survival. Antioxidants, 12.","DOI":"10.20944\/preprints202305.0677.v1"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/6\/972\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T10:16:29Z","timestamp":1773828989000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/6\/972"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":119,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["cancers18060972"],"URL":"https:\/\/doi.org\/10.3390\/cancers18060972","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]}}}