[The influence of hepatitis B virus infection on patients undergoing allogeneic hematopoietic stem cell transplantation].
OBJECTIVE
To investigate the prognosis and hepatitis B serologic marker changes in patients with HBV infection or with HBV infected donors after allogenic hematopoietic stem cell transplantation (allo-HSCT).


METHODS
The clinical outcomes of 79 patients receiving allo-HSCT, including 55 with HBV infection and 24 from HBV infected donors were analyzed retrospectively.


RESULTS
(1) HBV infection did not interfere with the clinical outcome of allo-HSCT. (2) In 20 HBsAg(+) patients, 13(65.0%) developed HBV reactivation between 0.5 and 10 months after transplantation, 9(45.0%) developed HBV-related hepatitis. (3) For the 35 HBsAg(-) and HBcAb/HBeAb positive patients, 4 (11.4%) occurred HBV seroconversion, 1 of the 4 complicated with severe chronic graft-versus-host disease (cGVHD). (4) There was a significant difference in HBV reactivation rate between the HBsAg(+) and HBsAg-groups (P < 0.01). The incidence of hepatitis occurred within 100 days after HSCT was high in HBsAg(+) patients (P < 0.05). (5) Clearance of HBsAg was observed in 2 HBsAg(+) patients, both of whom received graft from HBsAb positive donors.


CONCLUSIONS
Donors or recipients infected with HBV is not considered an absolute contraindication for HSCT, but HBsAg positivity is a high risk factor for HBV reactivation and prophylactic lamivudine treatment may be helpful. For patients with HBcAb/HBeAb positivity, seroconversion can be observed, especially after immunosuppressant withdrawal. Adoptive immunity is effective in clearing HBV in these patients.
Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
Chen
C
Liang
Er-Lie
EL
Jiang
Yong
Y
Huang
Zhang-Song
ZS
Yan
Dong-Lin
DL
Yang
Yi
Y
He
Qiao-Ling
QL
Ma
Jia-Lin
JL
Wei
Mei
M
Wang
Si-Zhou
SZ
Feng
Lu-Gui
LG
Qiu
Ming-Zhe
MZ
Han
D018380:Hematopoietic Stem Cell Transplantation; D006509:Hepatitis B / Q000453:epidemiology; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D006515:Hepatitis B virus; D006801:Humans
D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens