Long-term follow-up of HCV-infected hematopoietic SCT patients and effects of antiviral therapy

• Published in: Bone marrow transplantation (Basingstoke) Vol. 47; no. 9; pp. 1217 - 1221
• Main Authors: Ljungman, P, Locasciulli, A, de Soria, V G, Békássy, A N, Brinch, L, Espigado, I, Ferrant, A, Franklin, I M, O'Riordan, J, Rovira, M, Shaw, P, Einsele, H
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-09-2012; Nature Publishing Group
• Subjects: 631/326/596/1296; 692/699/255/234/2513/1551; 692/700/565/545/576/1955; Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antiviral agents; Antiviral Agents - adverse effects; Antiviral Agents - therapeutic use; antiviral therapy; Autografts; Biological and medical sciences; Bone marrow; Bone marrow, stem cells transplantation. Graft versus host reaction; Care and treatment; Cell Biology; Child; Child, Preschool; Cirrhosis; Clinical Medicine; Cohort Studies; Complications; Dosage and administration; Female; Follow-Up Studies; Graft-versus-host reaction; Hematologic Diseases - surgery; Hematologic Diseases - virology; Hematology; Hematopoietic Stem Cell Transplantation - methods; Hematopoietic stem cells; Hepatitis C; Hepatitis C - drug therapy; Hepatitis C - physiopathology; Hepatitis C virus; Humans; Infant; Infant, Newborn; Interferon; Internal Medicine; Klinisk medicin; late effects; Liver; Liver cirrhosis; Liver diseases; Liver transplantation; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Middle Aged; Morbidity; original-article; Patients; Pediatrics; Pediatrik; Prospective Studies; Public Health; Ribavirin; Side effects; Stem cell transplantation; Stem Cells; Survival Analysis; Survivors; Therapy; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Treatment Outcome; Viruses; Young Adult; Sweden; Hepatitis C virus; antiviral therapy; late effects; Human; Late; Hematology; Long term; Virus; Infection; Treatment; Follow up study; Antiviral; Flaviviridae; Hepacivirus; Hematopoietic stem cell transplantation
• ISSN: 0268-3369; 1476-5365; 1476-5365
• DOI: 10.1038/bmt.2011.238

This prospective study was initiated in 1993 with the aim to study late effects and responses to antiviral therapy in a cohort of hepatitis C virus (HCV)-infected patients. A total of 195 patients were included from 12 centers. In all, 134 patients had undergone allogeneic and 61 autologous hematopoietic SCT (HSCT). The median follow-up from HSCT is currently 16.8 years and the maximum 27.2 years. Overall 33 of 195 patients have died of which 6 died from liver complications. The survival probability was 81.6% and the cumulative incidence for death in liver complications was 6.1% at 20 years after HSCT. The cumulative incidence of severe liver complications (death from liver failure, cirrhosis and liver transplantation) was 11.7% at 20 years after HSCT. In all, 85 patients have been treated with IFN; 42 in combination with ribavirin. The sustained response rate was 40%. The rates of severe side effects were comparable to other patient populations and no patient developed significant exacerbations of GVHD. Patients receiving antiviral therapy had a trend toward a decreased risk of severe liver complications (odds ratio=0.33;
P
=0.058). HCV infection is associated with morbidity and mortality in long-term survivors after HSCT. Antiviral therapy can be given safely and might reduce the risk for severe complications.