title: Treatment of chronic hepatitis C virus in allogeneic bone marrow transplant recipients.
abstract: 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.
authors.affiliation: Service d'Hématologie - Greffe de Moelle Osseuse, et Université Paris VII, Hôpital Saint Louis, Paris Cedex, France.
authors.forename: R
authors.initials: R
authors.lastname: Peffault de Latour
authors.forename: T
authors.initials: T
authors.lastname: Asselah
authors.forename: V
authors.initials: V
authors.lastname: Lévy
authors.forename: C
authors.initials: C
authors.lastname: Scieux
authors.forename: A
authors.initials: A
authors.lastname: Devergie
authors.forename: P
authors.initials: P
authors.lastname: Ribaud
authors.forename: H
authors.initials: H
authors.lastname: Espérou
authors.forename: R
authors.initials: R
authors.lastname: Traineau
authors.forename: E
authors.initials: E
authors.lastname: Gluckman
authors.forename: D
authors.initials: D
authors.lastname: Valla
authors.forename: P
authors.initials: P
authors.lastname: Marcellin
authors.forename: G
authors.initials: G
authors.lastname: Socié
mesh_terms: 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