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Microbial Issues

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

Bone Marrow Transplantation volume 47, pages 1217–1221 (2012)Cite this article

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Abstract

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.

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Acknowledgements

During the 15-year study period, investigators and data managers changed in several of the participating institutions. We therefore acknowledge the contributions that many individuals have given during the length of the study. The study was supported by the Stockholm Cancer fund and the European Leukemia Net by grants to Per Ljungman.

Author contributions: PL: study concept and methodology, data acquisition and interpretation, statistical analysis and manuscript writing; AL: study concept and methodology, data collection and commented on the manuscript; VGGS, AB, LB, IE, AF, IF, MR, PS: data collection, and commented on the manuscript; JOR, HE: study concept and methodology, data collection and commented on the manuscript. All authors approved the final version of the manuscript.

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Authors and Affiliations

  1. Department of Hematology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden

    P Ljungman

  2. Department of Pediatrics, Ospedale S. Camillo, Rome, Italy

    A Locasciulli

  3. Department of Hematology, Hospital la Princesa, Madrid, Spain

    V G de Soria

  4. Department of Pediatrics, Lund University Hospital, Lund, Sweden

    A N Békássy

  5. Department of Hematology, Rikshospitalet, Oslo, Norway

    L Brinch

  6. Department of Hematology and Hemotherapy, Hospital Virgen del Rocio, Seville, Spain

    I Espigado

  7. Department of Hematology, Cliniques Universitaires, St. Luc, Brussels, Belgium

    A Ferrant

  8. University of Glasgow, Glasgow, UK

    I M Franklin

  9. Department of Hematology, St. James Hospital. Trinity College, Dublin, Ireland

    J O'Riordan

  10. Department of Hematology and Oncology, Hospital Clinic, Barcelona, Spain

    M Rovira

  11. Oncology Unit, The Children's hospital at Westmead, Sydney, Australia

    P Shaw

  12. Department of Hematology and Oncology, University of Würzburg, Würzburg, Germany

    H Einsele

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  1. P Ljungman
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for the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation

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Correspondence to P Ljungman.

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Ljungman, P., Locasciulli, A., de Soria, V. et al. Long-term follow-up of HCV-infected hematopoietic SCT patients and effects of antiviral therapy. Bone Marrow Transplant 47, 1217–1221 (2012). https://doi.org/10.1038/bmt.2011.238

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  • DOI: https://doi.org/10.1038/bmt.2011.238

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