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• W2017304984 abstract "The incidence of liver related morbidity and mortality after allogeneic hematopoietic cell transplantation (Allo-HCT) in patients positive for hepatitis B surface antigen (HBsAg +) may increase, but it has been not well analysed. The aim of this study is to determine the frequency of HBV reactivation and to evaluate the effect of HBV reactivation on early transplant-related complications in a retrospective single center cohort. We detected HbsAg+ 23 patients (3.8%) who underwent allo-HCT (n=680) within 10 years. Median age was 33 years. Twenty-two were male and one female. Liver function tests were normal and HBV-DNA negative in 20 patients prior to the transplant. Myeloablative (n=20) or fludarabine based-reduced intensity conditioning regimen (n=3) were used. Lamivudin prophylaxis was initiated 100 mgp.o o.d. in 14 patients with conditioning regimen and was continued until 6-12 months after the cessation of immunosuppresion at posttransplant period. Six patients had HBsAg+ donor, 5 seropositive (antiHBs with antiHBc IgG, 3 antiHBs alone and 6 were negative HBV naive. We could not obtain enough data about HBV serology of 3 donors. HBV reactivation was observed in 7 patients after median 4.5 months (range, 0.87-23.5) after the Allo-HCT. All the patients with HBV reactivation had received myeloablative conditioning. There was an increase of serum ALT (2.5×UNL- 54 UNL) level with positivity for HBV-DNA during reactivation. The reactivation was observed only in one patient during lamivudine prophylaxis 7.6% vs 60%. p=0.012) while one patient experienced a reactivation in 2 months after cessation of prophylaxis. Two patients with HBV reactivation had donors positive for HBsAg. Lamivudin treatment was given in 5 patients after reactivation. Lamivudin resistance was observed in two patients, who received second line antiviral treatment. One of those patients died of fulminant hepatic failure. The incidences of acute or chronic liver graft versus host disease were not affected from HBV reactivation. The reactivation HBV is one of the most undesired complications of chemo/immunosuppressive treatment in HBsAg positive Allo-HCT recipients. The prophylaxis with lamivudine could decrease the frequency of HBV reactivation. But the development of the lamivudine resistance is another problem in some patients requiring long-term treatment. In conclusion, our study has shown that HBsAg+ recipients did not have a strict limitation for allo-HCT." @default.
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• W2017304984 date "2010-02-01" @default.
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• W2017304984 title "Allogeneic Hematopoetic Cell Transplantation In Patients Positive For Hepatitis B Surface Antigen" @default.
• W2017304984 doi "https://doi.org/10.1016/j.bbmt.2009.12.395" @default.
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