title: Impact of hepatitis C virus infection on clinical outcome in recipients after allogeneic hematopoietic cell transplantation.
abstract: The impact of hepatitis C virus (HCV) infection on outcomes following allogeneic hematopoietic cell transplantation (HCT) remains a matter of debate. We have retrospectively examined the significance of HCV infection among recipients who received allogeneic HCT, using a Japan transplant outcome registry database between 2006 and 2009. Among 7,831 recipients, 136 were HCV-positive. The rate of hematopoietic recovery was lower in the HCV-positive group (neutrophil recovery of 500 × 10(6) /L or higher: 79% vs. 87% at Day 30, P = 0.087; platelet recovery of 50 × 10(9) /L or higher: 57% vs. 65% at Day 60, P = 0.012). The HCV-positive group had a significantly higher incidence of nonrelapse mortality 38% vs. 25% at 2 years, P < 0.01) and inferior overall survival (41% vs. 51% at 2 years, P < 0.01). A multivariate analysis revealed that HCV seropositivity was associated with an independent risk for higher nonrelapse mortality (hazard ratio: 1.65, P < 0.01) and inferior overall survival (hazard ratio: 1.39, P < 0.01). The incidences of death due to hepatic problems (8% vs. 2%, P < 0.01), bacterial infection (10% vs. 4%, P < 0.01), or graft failure (5% vs. 2%, P = 0.084) tended to be higher in the HCV-positive group. HCV infection had an adverse impact on the clinical outcome following HCT, especially in the setting of unrelated transplantation. Careful evaluation before embarking on HCT and intensive assessment against complications are warranted in HCV-infected recipients.
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan. nakasone-tky@umin.ac.jp
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakasone
authors.forename: Saiko
authors.initials: S
authors.lastname: Kurosawa
authors.forename: Kimikazu
authors.initials: K
authors.lastname: Yakushijin
authors.forename: Shuichi
authors.initials: S
authors.lastname: Taniguchi
authors.forename: Makoto
authors.initials: M
authors.lastname: Murata
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ikegame
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Eto
authors.forename: Koichi
authors.initials: K
authors.lastname: Miyamura
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sakamaki
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Morishima
authors.forename: Tokiko
authors.initials: T
authors.lastname: Nagamura
authors.forename: Ritsuro
authors.initials: R
authors.lastname: Suzuki
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fukuda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006085:Graft Survival / Q000502:physiology; D006402:Hematologic Diseases / Q000601:surgery* / Q000821:virology*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D016174:Hepacivirus / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult