Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Case Report
  • Published:

Aggressive hepatocellular carcinoma complicating pregnancy after autologous bone marrow transplantation for non-Hodgkin's lymphoma

Bone Marrow Transplantation volume 29, pages 177–179 (2002)Cite this article

Abstract

In the Asia-Pacific region, autologous and allogeneic bone marrow transplantation (BMT) in patients infected with the hepatitis B virus (HBV) may be complicated by fatal hepatic failure due to viral reactivation. Survivors may suffer from accelerated hepatitis and cirrhosis. We report the first case of hepatocellular carcinoma (HCC) after autologous BMT for mediastinal B cell lymphoma. The tumor developed rampantly during a planned pregnancy 5 years after BMT. Less than 40 cases of HCC complicating pregnancy have been reported, and outcome is invariably poor. Immunosuppression and HBV reactivation after autologous BMT, as well as immune tolerance and hormonal changes associated with pregnancy may contribute to the rapid tumor growth. Biochemical and radiological surveillance for HCC should be strengthened in HBV carriers after BMT, especially in patients with the histology of chronic liver disease, or biochemical/ virological evidence of increased HBV activity.

Bone Marrow Transplantation (2002) 29, 177–179. doi:10.1038/sj.bmt.1703339

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Milligan DW, Ruiz De Elvira MC, Kolb HJ et al. Secondary leukaemia and myelodysplasia after autografting for lymphoma: results from the EBMT. EBMT Lymphoma and Late Effects Working Parties. European Group for Blood and Marrow Transplantation Br J Haematol 1999 106: 1020 1026

    Article  CAS  Google Scholar 

  2. Witherspoon RP, Fisher LD, Schoch G et al. Secondary cancers after bone marrow transplantation for leukemia or aplastic anemia New Engl J Med 1989 321: 784 789

    Article  CAS  Google Scholar 

  3. Socie G, Curtis RE, Deeg HJ et al. New malignant diseases after allogeneic marrow transplantation for childhood acute leukemia J Clin Oncol 2000 18: 348 357

    Article  CAS  Google Scholar 

  4. Lau GK, Liang R, Chiu EK et al. Hepatic events after bone marrow transplantation in patients with hepatitis B infection: a case controlled study Bone Marrow Transplant 1997 19: 795 799

    Article  CAS  Google Scholar 

  5. Lau GK, Lie AK, Kwong YL et al. A case-controlled study on the use of HBsAg-positive donors for allogeneic hematopoietic cell transplantation Blood 2000 96: 452 458

    CAS  PubMed  Google Scholar 

  6. Ho SK, Chan TM, Cheng IK, Lai KN . Comparison of the second-generation digene hybrid capture assay with the branched-DNA assay for measurement of hepatitis B virus DNA in serum J Clin Microbiol 1999 37: 2461 2465

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Arcese W, Iori AP . Pregnancy and secondary cancer after allogeneic bone marrow transplantation Bone Marrow Transplant 1999 23: 752

    Article  CAS  Google Scholar 

  8. Lau WY, Leung WT, Ho S et al. Hepatocellular carcinoma during pregnancy and its comparison with other pregnancy-associated malignancies Cancer 1995 75: 2669 2676

    Article  CAS  Google Scholar 

  9. Entezami M, Becker R, Ebert A et al. Hepatocellular carcinoma as a rare cause of an excessive increase in alpha-fetoprotein during pregnancy Gynecol Oncol 1996 62: 405 407

    Article  CAS  Google Scholar 

  10. Tan CK, Chow PK, Findlay M et al. Use of tamoxifen in hepatocellular carcinoma: a review and paradigm shift J Gastroenterol Hepatol 2000 15: 725 729

    Article  CAS  Google Scholar 

  11. Macdonald GA . Pathogenesis of hepatocellular carcinoma Clin Liver Dis 2001 5: 69 85

    Article  CAS  Google Scholar 

  12. Liang R, Lau GK, Kwong YL . Chemotherapy and bone marrow transplantation for cancer patients who are also chronic hepatitis B carriers: a review of the problem J Clin Oncol 1999 17: 394 398

    Article  CAS  Google Scholar 

  13. Locasciulli A, Testa M, Valsecchi MG et al. The role of hepatitis C and B virus infections as risk factors for severe liver complications following allogeneic BMT: a prospective study by the Infectious Disease Working Party of the European Blood and Marrow Transplantation Group Transplantation 1999 68: 1486 1491

    Article  CAS  Google Scholar 

  14. Strasser SI, Myerson D, Spurgeon CL et al. Hepatitis C virus infection and bone marrow transplantation: a cohort study with 10-year follow-up Hepatology 1999 29: 1893 1899

    Article  CAS  Google Scholar 

  15. Strasser SI, Sullivan KM, Myerson D et al. Cirrhosis of the liver in long-term marrow transplant survivors Blood 1999 93: 3259 3266

    CAS  Google Scholar 

  16. Lau GK, Lok AS, Liang RH et al. Clearance of hepatitis B surface antigen after bone marrow transplantation: role of adoptive immunity transfer Hepatology 1997 25: 1497 1501

    Article  CAS  Google Scholar 

  17. Strasser SI, McDonald GB . Hepatitis viruses and hematopoietic cell transplantation: A guide to patient and donor management Blood 1999 93: 1127 1136

    CAS  Google Scholar 

  18. Tang S, Lo CM, Chan TM, Lai KN . Early detection of hepatocellular carcinoma in hepatitis-B-positive renal transplant recipients J Surg Oncol 1999 72: 99 101

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Queen Mary Hospital, Hong Kong

    WY Au, AKW Lie, R Liang & GK Lau

  2. Department of Surgery, Queen Mary Hospital, Hong Kong

    CL Liu

  3. Department of Pathology, Queen Mary Hospital, Hong Kong

    TW Shek

Authors
  1. WY Au
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. AKW Lie
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. CL Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. TW Shek
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. GK Lau
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Au, W., Lie, A., Liang, R. et al. Aggressive hepatocellular carcinoma complicating pregnancy after autologous bone marrow transplantation for non-Hodgkin's lymphoma. Bone Marrow Transplant 29, 177–179 (2002). https://doi.org/10.1038/sj.bmt.1703339

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1703339

Keywords

This article is cited by

Search

Advanced search

Quick links