Yazarlar : Mikulska M, Nicolini L, Signori A,

Yayın : Clin Microbiol Infect.

Yayın Yılı : 2014

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/24575948

Konu : Kemik İliği Nakli

Literatür İçeriği :  HBsAg-negative/HBcAb-positive hematopoietic stem cell transplant (HSCT) recipients are at high risk of HBV reactivation. Allogeneic HSCT recipients from years 2000-2010 were evaluated in order to study the impact of being HBsAg-negative/HBcAb-positive in this population Overall, 137 of 764 patients (18%) were HBsAg-negative/HBcAb-positive before HSCT. Overall survival, non-relapse mortality (NRM), acute and chronic graft-versus-host-disease were similar in HBcAb-positive and HBcAb-negative patients. Reactivation occurred in 14 patients (10%), in median 19 months after HSCT (range 9-77). Cause-specific hazard for reactivation was decreased in case of HBV-immune/exposed donor (HRadjusted =0.12, 95%CI:0.02-0.96; p=0.045) and increased in patients who received rituximab treatment (HRadjusted =2.91, 95%CI:0.77-10.97; p=0.11). Competing risks analyses documented a protective role of HBV-immune/exposed donor (p=0.041) and an increased probability associated with the length of treatment with cyclosporine (p<0.001) and treatment with rituximab (but not with low-dose rituximab prophylaxis, p<0.001 at each landmark point). No differences in overall survival and NRM were found between patients with and without HBV reactivation. Donor's immunity was independently and consistently associated with a decreased risk of HBV reactivation, while rituximab and cyclosporine treatment increased the probability. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

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