The effect of viral hepatitis B and C on the outcome of allogenic bone marrow transplantation of patients with adult acute myeloid leukemia (Egyptian sample)

Abstract

Abstract Background Hematopoietic stem cell transplantation is now established as a standard therapeutic modality for different malignant and benign diseases. Hematopoietic stem cell transplantation has many complications. Infection and graft-versus-host disease (GVHD) remain the major source of morbidity and mortality in patients who undergo BMT. Aim The aim of this work was to investigate the effect of hepatitis B and hepatitis C (HCV) viral infection on the outcome of fully matched sibling donor peripheral blood stem cell transplantation in patients with acute myeloid leukemia (AML). Patients and methods A total of 328 patients with AML who received allogeneic PBSC transplantation using BU/CY or FLU/BU conditioning regimen after the consent of the Ethical Committee of Nasser Institute Hospital during the period from 1997 to December 2016 were included in this study with a follow-up of 12 months. Results In seropositive patients, neutrophil engraftment was reached at a median of 14.57 days and platelet engraftment was reached at a median of 12.7. However, in seronegative patients, neutrophil engraftment was reached at a median of 14.3 (P=0.287) and platelet engraftment was reached at a median of 12.66 (P=0.917). In seropositive patients, the incidence of SOS was 2.1%, acute GVHD grades 2–4 was reported in eight patients, whereas chronic GVHD was reported in nine patients. In seronegative patients, the incidence of SOS was 0.70% (P=0.33), acute GVHD grades 2–4 was reported in 30 patients (P=0.184), whereas chronic GVHD was reported in 45 patients (P=0.54). Overall survival for HCV seronegative and seropositive patients was 58.4 and 44.6%, respectively (P=0.001), whereas disease-free survival for HCV seronegative and seropositive patients was 56.9 and 43.4%, respectively (P=0.0001). Conclusion Analysis of 46 HCV-positive adult AML patients and 282 HCV seronegative patients who had peripheral blood stem cell transplantation shows that HCV infection does not affect platelet or neutrophil engraftment or the incidence of SOS. HCV viremia did not show a significant effect on the incidence of acute and chronic GVHD. We also documented that there is a significant effect of HCV on both the disease-free survival and overall survival.