Incidence and morbidity of infection by hepatitis C virus in children with acute lymphoblastic leukaemia
A group of 90 patients with acute lymphoblastic leukaemia (ALL) in first continuous complete remission (CCR), admitted in our hospital between January 1986 and September 1992, were tested for the presence of antibodies against hepatitis C virus (HCV), antibodies against hepatitis B virus and antibodies against HIV-1 during maintenance therapy or thereafter. They were compared with a group of 71 children with other malignancies in first CCR who had been diagnosed consecutively from January 1986 to September 1992. No patient with ALL or any other malignancy was found to be positive for hepatitis B surface antigen or HIV-1. HCV-specific antibodies were detected in 28 out of 87 children (32.1%) with ALL and in 4 out of 44 patients (9%) with malignancies other than ALL who had received at least one transfusion of blood or platelets (P<0.01). HCV-specific antibodies were also detected in one out of three untransfused children with ALL but in none of the untransfused children with malignancies other than ALL. HCV-specific seropositivity influenced the management of children with ALL during maintenance therapy. In fact, as a result of abnormal liver function tests, maintenance therapy had to be suspended significantly more often in the case of HCV-seropositive patients with ALL than in HCV-seronegative ones. Despite the high morbidity during maintenance therapy, chronic liver disease (CLD) was uncommon in both groups: five children with ALL (17.2% of HCV-seropositive children) and one child with a malignancy other than ALL (25%) had CLD. If a follow up for a longer period confirms these observations the impact of HCV-related CLD on the quality of life and survival of patients with ALL or other malignancies will probably be minimal.
Key wordsAcute lymphoblastic leukaemia Hepatitis C virus
acute lymphoblastic leukaemia
continuous complete remission
chronic liver disease (biochemically evident)
hepatitis B virus
hepatitis C virus
Unable to display preview. Download preview PDF.
- 13.Kolho E, Ruutu P, Ruutu T (1993) Hepatitis C infection in BMT patients. Bone Marrow Transplant 11: 119–123Google Scholar
- 15.Laureys G, Verelst H, Dhooge C, Leroux-Roels G, Van Renterghem L, Benoit Y, (1992) Hepatitis C in children with ALL. Abstracts. Proceedings of the S. I. O. P. XXIV Meeting. P 225: 447Google Scholar
- 24.Resti M, Azzari C, Rossi ME, Vullo C, Zammarchi E, Vierucci A (1992) Hepatitis C virus antibodies in a long-term follow-up of β-thalassemic children with acute and chronic non-A non-B hepatitis. Eur J Pediatr 573–576Google Scholar
- 25.Riehm H, Langerman HJ, Gadner H, Odenwald E, Henze G (1980) The Berlin childhood acute lymphoblastic leukemia therapy study, 1970–1976. Am J Pediatr Hematol 4: 299–306Google Scholar
- 27.Seeff LB, Buskell-Bales Z, Wringht EC, Durako SJ, Alter HJ, Iber FL, Hollinger FB, Gitnick GM, Knodell RG, Perillo RP, Stevens CE, Hollongsworth CG, and the National Heart, Lung, and Blood Institute Study Group (1992) Long-term mortality after transfusion-associated non-A, non-B hepatitis. N Engl J Med 327: 1906–1911PubMedGoogle Scholar