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Impact of hepatitis C virus infection on clinical outcome in recipients after allogeneic hematopoietic cell transplantation
Author(s) -
Nakasone Hideki,
Kurosawa Saiko,
Yakushijin Kimikazu,
Taniguchi Shuichi,
Murata Makoto,
Ikegame Kazuhiro,
Kobayashi Takeshi,
Eto Tetsuya,
Miyamura Koichi,
Sakamaki Hisashi,
Morishima Yasuo,
Nagamura Tokiko,
Suzuki Ritsuro,
Fukuda Takahiro
Publication year - 2013
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.23436
Subject(s) - medicine , hazard ratio , hepatitis c virus , gastroenterology , transplantation , incidence (geometry) , hematopoietic cell , hepatitis c , hematopoietic stem cell transplantation , hematology , immunology , virus , haematopoiesis , confidence interval , stem cell , biology , physics , optics , genetics
The impact of hepatitis C virus (HCV) infection on outcomes following allogeneic hematopoietic cell transplantation (HCT) remains a matter of debate. We have retrospectively examined the significance of HCV infection among recipients who received allogeneic HCT, using a Japan transplant outcome registry database between 2006 and 2009. Among 7,831 recipients, 136 were HCV‐positive. The rate of hematopoietic recovery was lower in the HCV‐positive group (neutrophil recovery of 500 × 10 6 /L or higher: 79% vs. 87% at Day 30, P = 0.087; platelet recovery of 50 × 10 9 /L or higher: 57% vs. 65% at Day 60, P = 0.012). The HCV‐positive group had a significantly higher incidence of nonrelapse mortality 38% vs. 25% at 2 years, P < 0.01) and inferior overall survival (41% vs. 51% at 2 years, P < 0.01). A multivariate analysis revealed that HCV seropositivity was associated with an independent risk for higher nonrelapse mortality (hazard ratio: 1.65, P < 0.01) and inferior overall survival (hazard ratio: 1.39, P < 0.01). The incidences of death due to hepatic problems (8% vs. 2%, P < 0.01), bacterial infection (10% vs. 4%, P < 0.01), or graft failure (5% vs. 2%, P = 0.084) tended to be higher in the HCV‐positive group. HCV infection had an adverse impact on the clinical outcome following HCT, especially in the setting of unrelated transplantation. Careful evaluation before embarking on HCT and intensive assessment against complications are warranted in HCV‐infected recipients. Am. J. Hematol. 88:477–484, 2013. © 2013 Wiley Periodicals, Inc.