Feasibility of autologous stem cell transplantation in chronic carriers of hepatitis B and hepatitis C virus.
There are several reports describing acute liver decompensation in chronic carriers of HBsAg after withdrawal of chemotherapy or immunosuppressive therapy; recently the same was also reported for chronic HCV-RNA carriers. We retrospectively evaluated hepatic toxicity in eleven patients (6 carriers of HCV-RNA and 5 of HBsAg) autotransplanted at our Institution between March '92 and June '98. Male/female ratio was 7/4, median age 41 years (26-56). Nine patients (4 HBsAg) were affected by non-Hodgkin's lymphoma, 1 (HCV-RNA) by chronic myelogenous leukaemia and 1 (HBsAg) by breast cancer. In the immediate post-transplant period in only 1 patient (HBsAg carrier and affected by breast cancer) was hepatitis documented (at about 1 month from transplant) with an elevation of transaminase levels (x20-40 n.v.). Neither other complications, nor toxic deaths were observed. During the post-transplant follow-up (median 31 months, range 9-83) no hepatic abnormalities were observed. All patients are alive at 56 months (20-122) from diagnosis. Currently 10/11 patients are in complete remission, while 1 patient, affected by follicular centre lymphoma, is alive with disease 52 months from autologous stem cell transplantation. Our study shows that both conventional therapy and high-dose chemotherapy can be performed safely in chronic hepatitis B and C virus carriers.
Sperotto
A
A
Department of Medical and Morphological Research, University Hospital, Udine, Italy.
Silvestri
F
F
Fanin
R
R
Damiani
D
D
Geromin
A
A
Cerno
M
M
Stocchi
R
R
Patriarca
F
F
Baccarani
M
M
D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D002066:Busulfan / Q000627:therapeutic use; D002353:Carrier State; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D019694:Hepatitis B, Chronic / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D008223:Lymphoma / Q000150:complications* / Q000188:drug therapy / Q000628:therapy* / Q000821:virology; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous
D018906:Antineoplastic Agents, Alkylating; D002066:Busulfan; D008558:Melphalan