High-Dose Vitamin C in G6PDA and Pyruvate Kinase Deficiency: A Safety Study

Study Summary

This study is testing whether high-dose Vitamin C is safe and well-tolerated in patients with two inherited red blood cell disorders - Pyruvate Kinase Deficiency (PKD) and Class A Glucose-6-Phosphate Dehydrogenase Deficiency (G6PDA). Both conditions cause red blood cells to break down too quickly, leading to anemia and related complications. Our earlier research showed that a single oral dose of Vitamin C (250 mg, 500 mg, or 750 mg) reduced red blood cell breakdown by approximately 50% within one hour. This study builds on those findings by testing different doses and frequencies of Vitamin C to find the safest and most effective dosing schedule. Participants will take Vitamin C once, twice, or three times daily over a 3-week period, with careful monitoring of blood counts, red blood cell survival, iron levels, and any side effects. The study will first enroll 3 adult patients with PKD at Huntsman Cancer Institute. If the results are safe and promising, the study will be extended to patients with G6PDA deficiency, and eventually to children ages 4 and older at Primary Children's Hospital in Salt Lake City. The goal is to establish a foundation for Vitamin C as a novel therapy to reduce anemia and red blood cell destruction in these rare inherited disorders.

Primary Outcome

Number of participants experiencing Grade 3 or higher adverse events as defined by NCI CTCAE v5.0 that are possibly, probably, or definitely related to oral Vitamin C administration at each dose level (250 mg, 500 mg, and 750 mg) and dosing frequency (once daily, twice daily, and three times daily). Hematologic DLTs include Grade ≥3 hemolysis above patient baseline, Grade ≥3 anemia (hemoglobin \<8 g/dL), Grade 4 neutropenia (ANC \<0.5 × 10⁹/L), and Grade 4 thrombocytopenia (platelet count \<25 ×

Interventions

• DRUG Vitamin C