Horse antilymphocytic globulin in hepatitis B exacerbation after bone marrow transplantation adoptive immunity transfer

doi:doi:10.1038/sj.bmt.1704471

Bone Marrow Transplantation (2004) 33, 1057–1059. doi:10.1038/sj.bmt.1704471 Published online 29 March 2004

Horse antilymphocytic globulin in hepatitis B exacerbation after bone marrow transplantation adoptive immunity transfer

C Favre¹, M C Menconi¹, M Nardi¹, G Casazza¹, F Oliveri², P Macchia¹, F Bonino² and M R Brunetto²

¹Unità Trapianto di Midollo, Clinica Pediatrica I, Italy
²UO Gastroenterologia ed Epatologia, Azienda Ospedaliera-Universitaria Pisana, Pisa, Italy

Correspondence: Dr C Favre, BMT Unit, Department of Pediatrics, Via Roma 67, 56126 Pisa, Italy. E-mail: c.favre@med.unipi.it

Received 22 March 2003; Accepted 12 December 2003; Published online 29 March 2004.

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Abstract

We describe the case of a HBsAg+, HBeAg+ carrier, treated with lamivudine, who experienced exacerbation of hepatitis after BMT from an anti-HBs+, anti-HBc+, anti-HBe+ donor. The serological profile of the donor and the timing of exacerbation suggested that the adoptive immunity transfer played a major pathogenetic role. Antilymphocyte globulin administration resulted in resolution of hepatitis and seroconversion to anti-HBs+. Therapy aimed at blocking the effector arm of liver damage could represent a novel approach to avoid the risk of progression to fulminant hepatitis without hampering the chances of recovery from hepatitis B.