Treatment of chronic hepatitis C virus in allogeneic bone marrow transplant recipients.
We recently reported an increased incidence of cirrhosis in hepatitis C virus (HCV)-infected stem cell transplant (SCT) recipients. Here, we describe our experience in the treatment of these patients, which has been, to date, poorly reported in the literature. Among 99 HCV-infected HCT recipients, 36 had HCV-related liver lesions on biopsy requiring therapy. Owing to HCV treatment contraindications, only 61% of patients (22/36) could be treated. In all, 12 patients received more than one course of anti-HCV treatment if they had HCV RNA still detectable after the first course of treatment and no treatment contraindications. Combined therapy (pegylated interferon (IFN): n=9, or standard IFN: n=9, in combination with ribavirin) led to sustained virological response in 4/18 (20%) patients as compared to 2/20 (10%) in patients who received IFN alone. Hematological toxicity was more frequent with combined therapy. While anemia responded to erythropoietin and/or dose modification, thrombocytopenia usually led to treatment interruption (n=3). This study thus highlights the efficacy of combined therapy and emphasizes the fact that the undue safety concerns are not a problem when treating this particular population.
Peffault de Latour
R
R
Service d'Hématologie - Greffe de Moelle Osseuse, et Université Paris VII, Hôpital Saint Louis, Paris Cedex, France.
Asselah
T
T
Lévy
V
V
Scieux
C
C
Devergie
A
A
Ribaud
P
P
Espérou
H
H
Traineau
R
R
Gluckman
E
E
Valla
D
D
Marcellin
P
P
Socié
G
G
D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000628:therapy; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D005260:Female; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000635:transmission; D006650:Histocompatibility Testing; D006801:Humans; D015994:Incidence; D007938:Leukemia / Q000628:therapy; D008111:Liver Function Tests; D019520:Living Donors; D008297:Male; D014184:Transplantation, Homologous