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Autologous hematopoietic cell transplantation for myeloma patients with hepatitis B virus or hepatitis C virus in the era of novel agents

Bone Marrow Transplantation volume 57, pages 846–848 (2022)Cite this article

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Hepatitis B virus (HBV) and hepatitis C virus (HCV) are common blood-borne infections. The frequency of HBV reactivation in myeloma patients has increased in the era of novel agents because bortezomib administration may be considered a possible risk factor for HBV reactivation [1, 2]. In allogeneic hematopoietic cell transplantation (allo-HCT), liver complications are well recognized in patients with HCV infection [3, 4]. However, no consensus has been reached concerning HBV or HCV infection influence on autologous HCT (auto-HCT) outcomes in myeloma patients. Here we present the first large retrospective analysis demonstrating the impact of HBV or HCV infection on outcomes in myeloma patients who have undergone auto-HCT.

A total of 4735 patients aged ≥16 years, who received first auto-HCT for myeloma with peripheral blood stem cells performed between 2007 and 2018. HBV positivity was defined as the presence of either the HBV core antibody or surface antigen. HCV positivity was defined as the presence of anti-HCV antibodies. Moreover, detailed viral load data were unavailable for both HBV and HCV. We excluded HBV- and HCV-coinfected patients from the analyses because of their small number. High-risk cytogenetic abnormalities of fluorescence in situ hybridization analyses are partially performed in Japan because of issues with insurance coverage. Thus, the variable “cytogenetic risk” was excluded from the analysis. Overall survival (OS) was estimated using the Kaplan–Meier method and compared between groups using the log-rank test. One-year transplant-related mortality (TRM) was estimated using a cumulative incidence analysis and compared between groups using Gray’s test. Multivariate analysis was conducted using the Cox proportional hazards model for OS. All p-values were from two-tailed tests; p-values <0.05 indicated statistical significance. All statistical analyses were performed using EZR (Saitama Medical Center, Jichi Medical University, Saitama, Japan), a graphical user interface for the R (The R Foundation for Statistical Computing, version 2.7–0) [5].

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Fig. 1: Transplant outcomes.

Data availability

Datasets from the Transplant Registry Unified Management Program database are not publicly available outside of working groups. Access to these datasets requires permission from the commission. The corresponding author can be contacted at shohei@aichi-med-u.ac.jp if the details of datasets are required.

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Acknowledgements

The authors would like to thank Ms. Y. Oohigashi for her valuable secretarial assistance and all physicians and staff in the collaborating institutes of the Japan Society for Transplantation and Cellular Therapy (JSTCT). This work was supported in part by the Practical Research Project for Allergic Diseases and Immunology (Research Technology of Medical Transplantation) of the Japan Agency for Medical Research and Development, AMED, under grant number 18ek0510023h0002.

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Authors and Affiliations

  1. Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan

    Shohei Mizuno, Akiyoshi Takami & Ichiro Hanamura

  2. Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences/ Faculty of Transdisciplinary Sciences, Institute of Transdisciplinary Sciences, Kanazawa University, Kanazawa, Japan

    Hiroyuki Takamatsu

  3. Department of Hematology, Kyoto University Hospital, Kyoto, Japan

    Yutaka Shimazu

  4. Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan

    Akira Hangaishi

  5. Division of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan

    Nobuhiro Tsukada

  6. Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan

    Shinichi Kako & Yoshinobu Kanda

  7. Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan

    Taku Kikuchi

  8. Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan

    Shuichi Ota

  9. Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan

    Hiroaki Shimizu

  10. Department of Hematology and Oncology, Nagoya City University Hospital, Nagoya, Japan

    Shinsuke Iida

  11. Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan

    Satoshi Yoshioka

  12. Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan

    Masashi Sawa

  13. Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan

    Takahiro Fukuda

  14. Division of Hematology, Jichi Medical University, Shimotsuke, Japan

    Yoshinobu Kanda

  15. Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan

    Yoshiko Atsuta

  16. Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan

    Yoshiko Atsuta

  17. Department of Hematology, Tottori University Hospital, Yonago, Japan

    Koji Kawamura

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  1. Shohei Mizuno
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Contributions

SM designed the research, analyzed the data, performed the statistical analysis, and wrote the first draft of the manuscript. AT, HT, IH, YS, and KK contributed to the critical review of the manuscript. All the other authors contributed to data collection. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Shohei Mizuno.

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Competing interests

The authors declare no competing interests.

Ethical approval

This study was designed by the Multiple Myeloma Working Group of the JSTCT and approved by the Transplant Registry Unified Management Program Data Management Committee of the JSTCT and the Institutional Review Board of Aichi Medical University, where the study was conducted. Informed consent was obtained from each patient.

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Mizuno, S., Takami, A., Takamatsu, H. et al. Autologous hematopoietic cell transplantation for myeloma patients with hepatitis B virus or hepatitis C virus in the era of novel agents. Bone Marrow Transplant 57, 846–848 (2022). https://doi.org/10.1038/s41409-022-01640-7

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  • DOI: https://doi.org/10.1038/s41409-022-01640-7

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