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International Journal of Hematology

, Volume 75, Issue 3, pp 324–331 | Cite as

Retrospective Study on the Impact of Hepatitis B and Hepatitis C Virus Infection on Hematopoietic Stem Cell Transplantation in Japan

  • Motohiro Hamaguchi
  • Hironori Yamad
  • Hisashi Gondo
  • Yoshinobu Takemoto
  • Yasuo Morishima
  • Yoshihisa Kodera
Case Report

Abstract

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.

Key words

Stem cell transplant HBV HCV Hepatitis Hepatic failure 

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Copyright information

© The Japanese Society of Hematology 2002

Authors and Affiliations

  • Motohiro Hamaguchi
    • 1
  • Hironori Yamad
    • 1
  • Hisashi Gondo
    • 2
  • Yoshinobu Takemoto
    • 3
  • Yasuo Morishima
    • 4
  • Yoshihisa Kodera
    • 5
  1. 1.Department of HematologyNagoya National HospitalNagoya
  2. 2.First Department of Internal MedicineKyusyu University School of MedicineFukuoka
  3. 3.Second Department of Internal MedicineHyogo Medical UniversityNishinomiya
  4. 4.Department of Chemotherapy and HematologyAichi Cancer CenterNagoya
  5. 5.Department of HematologyJapanese Red Cross Nagoya First HospitalNagoyaJapan

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