Retrospective Study on the Impact of Hepatitis B and Hepatitis C Virus Infection on Hematopoietic Stem Cell Transplantation in Japan
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We performed a retrospective survey in 62 hematopoietic cell transplantation (HCT) centers in Japan in which all HCTs performed between 1986 and 1998 were reviewed, and those involving hepatitis B virus surface antigen (HBsAg)-positive donors were identified. One hundred and thirty-five patients who underwent allogeneic HCT (alloHCT) were studied for complications related to hepatitis B virus (HBV) or hepatitis C virus (HCV). The median follow-up period was 24 months. Positivity for HBsAg was observed in 32 patients (24%) throughout the study. Twenty-six of the 32 patients were HBsAg carriers before alloHCT, whereas the remaining 6 became HBsAg(+) after alloHCT. Forty-two recipients were anti-HBs antibody (HBsAb)-positive, and 58 recipients (43%) were HCV Ab(+). Eleven of 26 (42%) HBsAg(+) recipients survived between >4 and >119 months. Six of 26 cases received transplants from HBsAg(+) donors, and, although they had not developed acute graft-versus-host disease, 4 of 6 died of hepatic and renal failure within 10 months after HCT.After transplantation, 5 patients showed serologic evidence of HBV reactivation, whereas 4 patients showed evidence of an immune response to HBV. Viral reactivation occurred during the tapering of the immunosuppressive agent. However, 3 of 5 were alive at the time of this report, suggesting that reactivation is not directly correlated with severe liver dysfunction. Seventeen patients (13%) of 135 recipients developed hepatic failure. Eight (47%) of 17 were diagnosed with fulminant hepatitis and 5 (29%) with veno-occlusive disease (VOD). VOD was observed in 12% of both HBsAg(+) and HCVAb(+) patients. In this study, the relatively high incidence of HBV events occurred after alloHCT, and, therefore, we should consider a protocol for active immunization of donors and recipients against HBV. Moreover, although the presence of HBV or HCV is not a contraindication for alloHCT, we recommend a careful follow-up of recipients after transplantation, especially during immunosuppression tapering.
- Lau GKK, Liang R, Chiu EKW, Lee CK, Lam SK. Hepatic events after bone marrow transplantation in patients with hepatitis B infection: a case controlled study.Bone Marrow Transplant. 1997;19:795–799. CrossRef
- Ustun C, Koc H, Karayalcin S, et al. Hepatitis B virus infection in allogeneic bone marrow transplantation.Bone Marrow Transplant. 1997;20:289–296. CrossRef
- Strasser SI, McDonald GB. Hepatitis viruses and hematopoietic cell transplantation: a guide to patient and donor management.Blood. 1999;93:1127–1136.
- Chen YC, Lin KH, Huang WS, Tang JL. Bone marrow transplantation in Taiwan: an overview.Bone Marrow Transplant. 1994;13:705–708.
- Dhedin N, Douvin C, Kuentz M, et al. Reverse seroconversion of hepatitis B after allogeneic bone marrow transplantation.Transplantation. 1998;66:616–619. CrossRef
- Frickhofen N, Wiesneth M, Jainta C, et al. Hepatitis C virus infection is a risk factor for liver failure from veno-occlusive disease after bone marrow transplantation.Blood. 1994;83:1998–2004.
- Reed EC, Myerson D, Corey L, Meyers JD. Allogeneic marrow transplantation in patients positive for hepatitis B surface antigen.Blood. 1991;77:195–200.
- Rodriguez-Inigo E, Thomas JF, Gomez-Garcia de Soria V, et al. Hepatitis C and G virus infection and liver dysfunction after allogeneic bone marrow transplantation: results from a prospective study.Blood. 1997;90:1326–1331.
- Carreras E, Bertz H, Arcese W, et al. Incidence and outcome of hepatic veno-occlusive disease after blood or marrow transplantation: a prospective cohort study of the European group for blood and marrow transplantation.Blood. 1998;92:3599–3604.
- Locasciulli A, Testa M, Valsecchi MG. The role of hepatitis C and B virus infections as risk factors for severe liver complications following allogeneic BMT: a prospective study by the Infectious Disease Working Party of the European Blood and Marrow Transplantation Group.Transplantation. 1999;68:1486–1491. CrossRef
- Locasciulli A, Bacigalupo A, Van Lint MT, et al. Hepatitis B virus (HBV) infection and liver disease after allogeneic bone marrow transplantation: a report of 30 cases.Bone Marrow Transplant. 1990;6:25–29.
- Locasciulli A, Alberti A, Banbini G, et al. Allogeneic bone marrow transplantation from HbsAg+ donors: a multicenter study from the Gruppo Italiano Trapianto di Midollo Osseo (GITMO).Blood. 1995;86:3236–3240.
- Lau GKK, Lie A, Kwong YL, et al. A case-controlled study on the use of HbsAg(+) donors for allogeneic hematopoietic cell transplantation.Blood. 2000;96:452–458.
- Ustun C, Idilman R, Gurman G, et al. Hematopoietic stem cell transplantation from non-replicative hepatitis B virus carriers is safe.J Hepatol. 1999;31:202–209. CrossRef
- Fan FS, Tzeng CH, Yeh HM, et al. Reverse seroconversion of hepatitis B virus infectious status after allogeneic bone marrow transplantation from a carrier donor.Bone Marrow Transplant. 1991;8:417–420.
- Webster A, Brenner MK, Prentice HG, et al. Fatal hepatitis B reactivation after autologous bone marrow transplantation.Bone Marrow Transplant. 1989;4:207–213.
- Chen PM, Fan S, Liu CJ, et al. Changing of hepatitis B virus markers in patients with bone marrow transplantation.Transplantation. 1990;49:708–713. CrossRef
- Lai CL, Chien RN, Leung N, et al. A one-year trial of lamivudine for chronic hepatitis B.N Engl J Med. 1998;339:61–68. CrossRef
- Dienstag JL, Schiff ER, Wright TL, et al. Lamivudine as initial treatment for chronic hepatitis B in the United States.N Engl J Med. 1999;341:1256–1263. CrossRef
- Locasciulli A, Alberti A. Hepatitis B and hepatitis C virus infections in stem cell transplantation.Leuk Lymphoma. 1999;35:255–260. CrossRef
- Retrospective Study on the Impact of Hepatitis B and Hepatitis C Virus Infection on Hematopoietic Stem Cell Transplantation in Japan
International Journal of Hematology
Volume 75, Issue 3 , pp 324-331
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- Stem cell transplant
- Hepatic failure
- Industry Sectors
- Author Affiliations
- 1. Department of Hematology, Nagoya National Hospital, Nagoya
- 3. First Department of Internal Medicine, Kyusyu University School of Medicine, Fukuoka
- 4. Second Department of Internal Medicine, Hyogo Medical University, Nishinomiya
- 6. Department of Chemotherapy and Hematology, Aichi Cancer Center, Nagoya
- 7. Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan