CLINICAL IMPACT OF HEPATITIS B SURFACE ANTIGEN POSITIVITY IN PATIENTS UNDERGONE ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION
(Abstract release date: 05/21/15)
EHA Library. Yi H. 06/12/15; 102749; PB2025
Disclosure(s): Inha University, School of MedicineInha University Hospital
Hyeon Gyu Yi
Contributions
Contributions
Abstract
Abstract: PB2025
Type: Publication Only
Background
Hepatitis B virus (HBV)-related events could increase in patients who have HBV before or after allogeneic hematopoietic stem cell transplantation (HSCT) due to their immunosuppressive status because of their primary diseases, conditioning regimens, immunosuppressive agents, and immature immune reconstruction. However, the consensus of the risk of HBV status and prophylactic or therapeutic strategies for these patients were not settled yet.
Aims
We intented to search the clinical impact of HBV surface antigen (HBS Ag) positivity in patients undergone allogeneic hematopoietic stem cell transplantation.
Methods
We reviewed clinical information of HBS Ag-positive patients who had been treated with allogeneic HSCT for various hematologic diseases to evaluate the influence of HBsAg positivity to the clinical outcomes. A total of 398 patients who had been treated with allogeneic HSCT between January 1998 and November 2014 in three domestic institutes of Korea were enrolled in this study.
Results
Eleven patients (2.8%) were HBsAg-positive among 398 patients treated with allogeneic HSCT. The diagnosis were acute myeloid leukemia (N=3), acute lymphoblastic leukemia (N=1), non-Hodgkin lymphoma (N=1), myelodysplastic syndrome (N=2), severe aplastic anemia (N=3), and acute biphenotypical leukemia (N=1). Ten patients were HBsAg-positive before HSCT, and one patient became seroreversion after HSCT due to HBsAg-positive donor. Seven patients (63.6%) were given prophylactic antiviral agents (lamivudine, N=4; entecarvir, N=3). Three patients (27.3%) experienced chronic active hepatitis (CAH) after HSCT, which was controlled well with antiviral agents. Of three CAH patients, two had not been give any HBV prophylaxis during HSCT. Sinusosidal obstruction syndrome (SOS) occurred in 3 patients (27.3%), and one died of SOS. Acute liver graft-versus host disease (GVHD) occurred in 4 patients (36.4%); and chronic liver GVHD did in 2 (18.2%). Interestingly, one patient whose donor had HBs antibody (HBsAb) lost HBsAg after HSCT.
Summary
HBsAg positivity could increase the risk of the incidence of chronic active hepatitis after allogeneic HSCT. However, it seems not to influence markedly to the overall clinical outcomes of HSCT including survival, SOS or liver GVHD. Loss of HBsAg might be expected if the donor has HBsAb. Further large-scaled studies designed to identify the risk of HBsAg positivity and the optimal strategy for HBsAg-positive patients is required.
Keyword(s): Hematopoietic cell transplantation, Hepatitis B virus
Session topic: Publication Only
Type: Publication Only
Background
Hepatitis B virus (HBV)-related events could increase in patients who have HBV before or after allogeneic hematopoietic stem cell transplantation (HSCT) due to their immunosuppressive status because of their primary diseases, conditioning regimens, immunosuppressive agents, and immature immune reconstruction. However, the consensus of the risk of HBV status and prophylactic or therapeutic strategies for these patients were not settled yet.
Aims
We intented to search the clinical impact of HBV surface antigen (HBS Ag) positivity in patients undergone allogeneic hematopoietic stem cell transplantation.
Methods
We reviewed clinical information of HBS Ag-positive patients who had been treated with allogeneic HSCT for various hematologic diseases to evaluate the influence of HBsAg positivity to the clinical outcomes. A total of 398 patients who had been treated with allogeneic HSCT between January 1998 and November 2014 in three domestic institutes of Korea were enrolled in this study.
Results
Eleven patients (2.8%) were HBsAg-positive among 398 patients treated with allogeneic HSCT. The diagnosis were acute myeloid leukemia (N=3), acute lymphoblastic leukemia (N=1), non-Hodgkin lymphoma (N=1), myelodysplastic syndrome (N=2), severe aplastic anemia (N=3), and acute biphenotypical leukemia (N=1). Ten patients were HBsAg-positive before HSCT, and one patient became seroreversion after HSCT due to HBsAg-positive donor. Seven patients (63.6%) were given prophylactic antiviral agents (lamivudine, N=4; entecarvir, N=3). Three patients (27.3%) experienced chronic active hepatitis (CAH) after HSCT, which was controlled well with antiviral agents. Of three CAH patients, two had not been give any HBV prophylaxis during HSCT. Sinusosidal obstruction syndrome (SOS) occurred in 3 patients (27.3%), and one died of SOS. Acute liver graft-versus host disease (GVHD) occurred in 4 patients (36.4%); and chronic liver GVHD did in 2 (18.2%). Interestingly, one patient whose donor had HBs antibody (HBsAb) lost HBsAg after HSCT.
Summary
HBsAg positivity could increase the risk of the incidence of chronic active hepatitis after allogeneic HSCT. However, it seems not to influence markedly to the overall clinical outcomes of HSCT including survival, SOS or liver GVHD. Loss of HBsAg might be expected if the donor has HBsAb. Further large-scaled studies designed to identify the risk of HBsAg positivity and the optimal strategy for HBsAg-positive patients is required.
Keyword(s): Hematopoietic cell transplantation, Hepatitis B virus
Session topic: Publication Only
Abstract: PB2025
Type: Publication Only
Background
Hepatitis B virus (HBV)-related events could increase in patients who have HBV before or after allogeneic hematopoietic stem cell transplantation (HSCT) due to their immunosuppressive status because of their primary diseases, conditioning regimens, immunosuppressive agents, and immature immune reconstruction. However, the consensus of the risk of HBV status and prophylactic or therapeutic strategies for these patients were not settled yet.
Aims
We intented to search the clinical impact of HBV surface antigen (HBS Ag) positivity in patients undergone allogeneic hematopoietic stem cell transplantation.
Methods
We reviewed clinical information of HBS Ag-positive patients who had been treated with allogeneic HSCT for various hematologic diseases to evaluate the influence of HBsAg positivity to the clinical outcomes. A total of 398 patients who had been treated with allogeneic HSCT between January 1998 and November 2014 in three domestic institutes of Korea were enrolled in this study.
Results
Eleven patients (2.8%) were HBsAg-positive among 398 patients treated with allogeneic HSCT. The diagnosis were acute myeloid leukemia (N=3), acute lymphoblastic leukemia (N=1), non-Hodgkin lymphoma (N=1), myelodysplastic syndrome (N=2), severe aplastic anemia (N=3), and acute biphenotypical leukemia (N=1). Ten patients were HBsAg-positive before HSCT, and one patient became seroreversion after HSCT due to HBsAg-positive donor. Seven patients (63.6%) were given prophylactic antiviral agents (lamivudine, N=4; entecarvir, N=3). Three patients (27.3%) experienced chronic active hepatitis (CAH) after HSCT, which was controlled well with antiviral agents. Of three CAH patients, two had not been give any HBV prophylaxis during HSCT. Sinusosidal obstruction syndrome (SOS) occurred in 3 patients (27.3%), and one died of SOS. Acute liver graft-versus host disease (GVHD) occurred in 4 patients (36.4%); and chronic liver GVHD did in 2 (18.2%). Interestingly, one patient whose donor had HBs antibody (HBsAb) lost HBsAg after HSCT.
Summary
HBsAg positivity could increase the risk of the incidence of chronic active hepatitis after allogeneic HSCT. However, it seems not to influence markedly to the overall clinical outcomes of HSCT including survival, SOS or liver GVHD. Loss of HBsAg might be expected if the donor has HBsAb. Further large-scaled studies designed to identify the risk of HBsAg positivity and the optimal strategy for HBsAg-positive patients is required.
Keyword(s): Hematopoietic cell transplantation, Hepatitis B virus
Session topic: Publication Only
Type: Publication Only
Background
Hepatitis B virus (HBV)-related events could increase in patients who have HBV before or after allogeneic hematopoietic stem cell transplantation (HSCT) due to their immunosuppressive status because of their primary diseases, conditioning regimens, immunosuppressive agents, and immature immune reconstruction. However, the consensus of the risk of HBV status and prophylactic or therapeutic strategies for these patients were not settled yet.
Aims
We intented to search the clinical impact of HBV surface antigen (HBS Ag) positivity in patients undergone allogeneic hematopoietic stem cell transplantation.
Methods
We reviewed clinical information of HBS Ag-positive patients who had been treated with allogeneic HSCT for various hematologic diseases to evaluate the influence of HBsAg positivity to the clinical outcomes. A total of 398 patients who had been treated with allogeneic HSCT between January 1998 and November 2014 in three domestic institutes of Korea were enrolled in this study.
Results
Eleven patients (2.8%) were HBsAg-positive among 398 patients treated with allogeneic HSCT. The diagnosis were acute myeloid leukemia (N=3), acute lymphoblastic leukemia (N=1), non-Hodgkin lymphoma (N=1), myelodysplastic syndrome (N=2), severe aplastic anemia (N=3), and acute biphenotypical leukemia (N=1). Ten patients were HBsAg-positive before HSCT, and one patient became seroreversion after HSCT due to HBsAg-positive donor. Seven patients (63.6%) were given prophylactic antiviral agents (lamivudine, N=4; entecarvir, N=3). Three patients (27.3%) experienced chronic active hepatitis (CAH) after HSCT, which was controlled well with antiviral agents. Of three CAH patients, two had not been give any HBV prophylaxis during HSCT. Sinusosidal obstruction syndrome (SOS) occurred in 3 patients (27.3%), and one died of SOS. Acute liver graft-versus host disease (GVHD) occurred in 4 patients (36.4%); and chronic liver GVHD did in 2 (18.2%). Interestingly, one patient whose donor had HBs antibody (HBsAb) lost HBsAg after HSCT.
Summary
HBsAg positivity could increase the risk of the incidence of chronic active hepatitis after allogeneic HSCT. However, it seems not to influence markedly to the overall clinical outcomes of HSCT including survival, SOS or liver GVHD. Loss of HBsAg might be expected if the donor has HBsAb. Further large-scaled studies designed to identify the risk of HBsAg positivity and the optimal strategy for HBsAg-positive patients is required.
Keyword(s): Hematopoietic cell transplantation, Hepatitis B virus
Session topic: Publication Only
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