Original Article

Supportive Care in Cancer

, Volume 18, Issue 11, pp 1413-1420

Natural course of HCV infection in childhood cancer survivors

  • Francesca FioreddaAffiliated withDepartment of Pediatric Hematology, Oncology, and Bone Marrow Transplantation, Giannina Gaslini Children’s Hospital Email author 
  • , Andrea MoserAffiliated withDivision of Pediatric Hematology-Oncology, Medical University of Graz
  • , Luisella BertoluzzoAffiliated withDepartment of Infectious Diseases, Giannina Gaslini Children’s Hospital
  • , Herwig LacknerAffiliated withDivision of Pediatric Hematology-Oncology, Medical University of Graz
  • , Raffaella GiacchinoAffiliated withDepartment of Infectious Diseases, Giannina Gaslini Children’s Hospital
  • , Milena LaSpinaAffiliated withDepartment of Pediatric Hematology-Oncology, University of Catania
  • , Luisella LazierAffiliated withDepartment of Pediatrics, University of Turin
  • , Caterina RivaAffiliated withDepartment of Pediatrics, University of Turin
  • , Mareva GiacchinoAffiliated withDepartment of Pediatrics, University of Turin
    • , Donatella FraschiniAffiliated withPediatric Department, University of Milano-Bicocca, San Gerardo Hospital
    • , Eva FreyAffiliated withDepartment of Hematology and Oncology, St. Anna Children’s Hospital
    • , Angela SementaAffiliated withService of Pathology, Giannina Gaslini Children’s Hospital
    • , Angela PistorioAffiliated withEpidemiology and Biostatistics Section, Scientific Directorate, Giannina Gaslini Children’s Hospital
    • , Riccardo HauptAffiliated withEpidemiology and Biostatistics Section, Scientific Directorate, Giannina Gaslini Children’s Hospital
    • , On behalf of I-BFM ELTEC (Early and Late Toxicity Educational Committee)

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Abstract

Goals of work

To describe the course of hepatitis C in a cohort of 105 survivors after childhood cancer.

Patients and methods

Data on chemo/radiotherapy, clinical status, serial alanine aminotransferase (ALT) evaluation, and virological parameters after the end of treatment were collected for each patient. Liver biopsies, when performed, were centrally evaluated by a pathologist.

Main results

All patients were alive at the end of follow-up and did not show hepatic insufficiency. ALT evaluation along the entire follow-up showed a moderate (87%) or a remarkable (13%) cytolytic pattern. Young age at diagnosis, hematopoietic stem cell transplantation, and duration of infection significantly correlate with a worse hepatic activity. Type of tumor and chemo and/or radiotherapy regimens did not influence the pattern of hepatic cytolysis. Liver biopsy, centrally reviewed in 30% of the cohort, showed one case of cirrhosis and mild fibrosis in 71% of the group. Higher degrees of fibrosis did not seem to be related to any exposition to chemo/radiotherapy but correlated significantly with the more remarkable cytolytic course.

Conclusions

The outcome of hepatitis C in our patients is comparable to the one described in European cohorts of adult cancer survivors and perinatally infected subjects. Nevertheless, progression to high degrees of hepatic damage has to be monitored by a careful follow-up.

Keywords

Chronic hepatitis C Long-term survivors HCV after cancer