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ID 114638
Title Alternative
Retrospective single-center analysis of HBV reactivation in patients with hematological malignancies after allogenic hematopoietic stem cell transplantation
同種移植後のHBV再活性化の後方視的検討
Author
Sogabe, Kimiko Tokushima University
Tanaka, Hironori Tokushima University
Keywords
HBV reactivation
Allogenic hematopoietic stem cell transplantation
Hematological malignancies
Content Type
Journal Article
Description
Reactivation of hepatitis B has been recognized as a careful adverse event after chemotherapies or immunosuppressive therapies because chronic hepatitis B leads to carcinoma and/or liver cirrhosis. Allogenic hematopoietic stem cell transplantation(allo-HSCT)against hematological diseases induces severe immunosuppression including reconstitution of naïve donor immunity against HBV-infected hepatocytes and we therefore need to follow-up HBV testing for a long term. In order to establish how to follow-up HBV-infected patients with receiving allo-HSCT, we retrospectively studied HBV serological markers and HBV-DNA in the HBV-infected patients, who received allo-HSCT and followed-up more than 1 year in our single center. We detected 7 HBV-infected and allo-HSCT-received patients, and HBV reactivation was occurred in 3 patients with detecting HBV-DNA. No patients were died due to HBV reactivation. The HBV reactivation period after receiving allo-HSCT was 16,20,79 months, respectively. All the 3 patients received nucleoside analogues(NUCs); however, the appearance of viral mutation was occurred in one patient who received lamivudine and already detected HBs-Ag before allo-HSCT. The HBV reactivation was controlled with addition of adefovir. Others were due to discontinuation of entecavir, which reason was poor medication-adherence after stopping immunosuppressive therapies. These two patients received tenofovir alafenamide in addition or retreated with entecavir, respectively, leading to disappearing of HBV-DNA. HBs-Ab were disappeared in 31 months after allo-HSCT in one patient, and then the Ab was detected after occurring HBV reactivation, suggesting reconstitution of donor immunity. Taken together, our findings suggest that we need to follow-up immune-reconstitution and regularly evaluate HBV serological markers and HBV-DNA, in addition to maintain medication-adherence.
Journal Title
Shikoku Acta Medica
ISSN
00373699
NCID
AN00102041
Publisher
徳島医学会
Volume
75
Issue
5-6
Start Page
171
End Page
178
Sort Key
171
Published Date
2019-12-25
FullText File
language
jpn
TextVersion
Publisher
departments
University Hospital
Medical Sciences