Management of viral hepatitis in patients with haematological malignancy and in patients undergoing haemopoietic stem cell transplantation: recommendations of the 5th European Conference on Infections in Leukaemia (ECIL-5).
Viral hepatitis affects millions of people worldwide, and host immunity is the key determinant of patient outcome. Viral hepatitis can be life threatening in patients with haematological malignancy, including haemopoietic stem cell transplant recipients, because of the virus itself, or through a need to decrease the dose of chemotherapy. A past or currently infected haemopoietic stem cell donor could also transmit viral hepatitis. The burden of viral hepatitis in patients with haematological malignancies and the weak evidence on which previous guidelines are based has prompted the European Conference on Infection in Leukaemia (ECIL-5) to convene a group of experts in the fields of viral hepatitis and of haematological malignancy to specifically address previously unconsidered issues and grade the available quality of evidence according to the Infectious Diseases Society of America grading system. The group recommends that all patients should be screened for hepatotropic viruses before haematological treatment and that patients or haemopoietic stem cell donors with markers of past or current viral hepatitis should be assessed by an expert. Screening, vaccination, and treatment rules are reported in this Review.
Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Institut Pasteur, Institut National de la Santé et de la Recherche Médicale Unité 1223, Paris, France; Hepatology Service, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin Port-Royal, Paris, France. Electronic address: vincent.mallet@cch.aphp.fr.
Vincent
V
Mallet
Hepatology Section, University Hospital Leipzig, Leipzig, Germany.
Florian
F
van Bömmel
Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
Christopher
C
Doerig
University Medical Center Hamburg-Eppendorf, First Department of Medicine, Hamburg, Germany.
Sven
S
Pischke
Department of Haematology, Paris Descartes University, Imagine Institute, Necker Hospital, Paris, France.
Olivier
O
Hermine
Ematologia e Trapianto di Midollo, Ospedale SanCamillo, Roma, Italia.
Anna
A
Locasciulli
Haematology Department, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, and Paris-Est Créteil University, Créteil, France.
Catherine
C
Cordonnier
Hepatology Section, University Hospital Leipzig, Leipzig, Germany.
Thomas
T
Berg
Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
Darius
D
Moradpour
Hannover Centre for Internal Medicine, Hannover, Germany.
Heiner
H
Wedemeyer
Karolinska University Hospital, Department of Haematology and Karolinska Institutet, Department of Medicine, Huddinge, Stockholm, Sweden.
Per
P
Ljungman
D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006525:Hepatitis, Viral, Human / Q000188:drug therapy*; D006801:Humans; D007938:Leukemia / Q000150:complications* / Q000188:drug therapy