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ID 114638
タイトル別表記
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
著者
曽我部, 公子 徳島大学
田中, 宏典 徳島大学
キーワード
HBV reactivation
Allogenic hematopoietic stem cell transplantation
Hematological malignancies
資料タイプ
学術雑誌論文
抄録
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.
掲載誌名
四国医学雑誌
ISSN
00373699
cat書誌ID
AN00102041
出版者
徳島医学会
75
5-6
開始ページ
171
終了ページ
178
並び順
171
発行日
2019-12-25
フルテキストファイル
言語
jpn
著者版フラグ
出版社版
部局
病院
医学系