Stem Cell Transplantation

liver411

Eur J Haematol. 2003 Sep;71(3):220-14.  Related Articles, Links


Successful clearance of hepatitis B virus after allogeneic stem cell
transplantation: beneficial combination of adoptive immunity transfer and
lamivudine.

Chiba T, Yokosuka O, Goto S, Fukai K, Imazeki F, Shishido H, Narita M,
Saisho H.

Department of Medicine and Clinical Oncology, Graduate School of Medicine,
Chiba University, 1-8-1 Inohana, Chuo Ward, Chiba, Japan.

We report a 38-yr-old male with acute lymphocytic leukemia (ALL), whose
serological tests for the hepatitis B virus (HBV) before transplantation
showed a chronic carrier status, and a liver biopsy specimen revealed
chronic liver injury because of HBV. The patient underwent allogeneic
peripheral blood stem cell transplantation (PBSCT) from his sibling who was
hepatitis B surface antibody (HBsAb) positive. He had received lamivudine
treatment for the prophylaxis of HBV reactivation during cytotoxic
chemotherapy, and lamivudine administration continued after transplantation.
Successful engraftment was documented 3 wk after PBSCT, and clearance of the
hepatitis B surface antigen (HBsAg) was observed 2 months after PBSCT. Liver
function tests transiently showed a mild elevation of aminotransferases on
day 25, although this returned to normal after the dose escalation of the
immunosuppressive agent. We presume that the combination of adoptive
immunity transfer by bone marrow transplantation (BMT) from an
HBsAb-positive donor and antiviral drugs such as lamivudine is beneficial in
clearing HBV in chronic carriers.

PMID: 12930325 [PubMed - in process]