Abstract
Our two patients undergoing allogeneic bone marrow transplantation (AlloBMT) had both Hepatitis B virus (HBV) and graft-versus-host disease (GVHD). In the first patient,, liver enzymes elevated three months after AlloBMT, and GVHD was diagnosed. Two weeks after the diagnosis of GVHD, HBsAg appeared in his serum. At that time, liver biopsy was not able to discriminate two disorders, but his sequential liver biopsies disclosed GVHD. Despite the patient was treated with cyclosporin A (CsA), he died for chronic GVHD. In contrast to the first patient, the second patient had HBsAg prior to GVHD. His liver enzymes deterioration was detected in the first month after AlloBMT, and reached the highest level in the third month while withdrawing CsA. In the fifth month he developed scleradermatous skin changes, and skin biopsy revealed chronic GVHD, whereas concurrent liver biopsy revealed chronic active hepatitis. This observation showed that immunosuppressive conditions such as GVHD or its prophylaxis may affect the appearance of liver pathology caused by HBV, which depends on the time of GVHD development, and the duration and depth of GVHD prophylaxis.
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References
Atkinson K: Recostruction of the haemopoietic and immune systems after marrow transplantation. Bone Marrow Transplant 5:209–226, 1990.
ChenPM,FanS, LiuJE, et al: Reactivation of hepatitis B virus in two chronic GVHD patients after transplant. Int J Hematol 58:183–188,1993.
ChenPM, Fan S, PLiu CJ, et al: Changing of hepatitis B virus markers in patients with bone marrow transplantation. Transplantation 49:708–713, 1990.
Gerber MA, Thung SN: Biology of disease molecular and cellular pathology of hepatitis B.Lab Invest 53:572–590, 1985.
Hoofnagle JH, Dusheiko GM, Schafer DF, et al: Reactivation of chronic hepatitis B virus infection by cancer chemotherapy. Ann Int Med 96:447–449, 1982.
Lau GKK, Liang R, Chiu EKW et al: Hepatic events after bone marrow transplantation in patients with hepatitis B infection: a case controlled study. Bone Marrow Transplant 19:795–799, 1997.
Lawrence GL: Immune recovery after bone marrow transplantation. Hematol/Oncol Clin N Am 4:659–675, 1990.
Locasciulli A, Alberti A, Bock R, et al. Impact of liver disease and hepatitis infections on allogeneic bone marrow transplantation in Europe: a survey from the European Bone Marrow Transplantation (EBMT) Groupe - Infections Diseases Working Party. Bone Marrow Transplant 14:833–837, 1994.
Locasciulli A, Bacigalupo A, Vanlint MT et al: Hepatitis B virus infection and liver disease after allogeneic bone marrow transplantation. A report of 30 cases. Bone Marrow Transplant 6:25–29,1990.
Pariente EA, Goudeau, Dubois F, et al: Fulminant hepatitis due to reactivation of chronic hepatitis B virus infection after allogeneic bone marrow transplantation. Dig Dis Sci 33:1185–1191, 1988.
Ustun C, Koç H, Karayalç n S, et al: Hepatitis B virus infection in allogeneic bone marrow transplantation. Bone Marrow Transplant 20:289–296, 1997.
Ustun C, Idilman R, Gürman G, et al. Hematopoietic stem cell transplantation in patients with non-replicative hepatitis B virus carriers is safe. J Hepatol (in press).
Webster A, Brenner MK, Prentice EG, et al: Fatal hepatitis B reactivation after autologous bone marrow transplantation. Bone Marrow Transplant 49:708–713, 1989.
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ÜstÜn, C., Özcan, M., GÜrman, G. et al. Differences in liver pathology and clinical outcome between two patients with hepatitis B virus and graft verses host disease. Pathol. Oncol. Res. 5, 229–232 (1999). https://doi.org/10.1053/paor.1999.0229
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DOI: https://doi.org/10.1053/paor.1999.0229