Cancer Res Treat.  2018 Oct;50(4):1121-1129. 10.4143/crt.2017.329.

HBsAg-Negative, Anti-HBc–Negative Patients Still Have a Risk of Hepatitis B Virus–Related Hepatitis after Autologous Stem Cell Transplantation for Multiple Myeloma or Malignant Lymphoma

• Park H
• Kim DY
• Kim SJ
• Chung H
• Cho H
• Jang JE
• Cheong JW
• Min YH
• Song JW
• Kim JS

• KMID: 2424785
• DOI: http://doi.org/10.4143/crt.2017.329

Abstract

PURPOSE
Although hepatitis B surface antigen (HBsAg)-negative, hepatitis B core antibody (anti-HBc)-negative patients are not considered to be at risk for hepatitis B virus (HBV)-related hepatitis, the actual risk remains to be elucidated. This study aimed to evaluate the risk of HBV-related hepatitis in HBsAg-negative, anti-HBc-negative patients receiving autologous stem cell transplantation (ASCT) for multiple myeloma (MM) or malignant lymphoma.
MATERIALS AND METHODS
We retrospectively reviewed data from 271 HBsAg-negative patients (161 anti-HBc-negative and 110 anti-HBc-positive at the time of ASCT) who received ASCT for MM or lymphoma. The risk of HBV-related hepatitis was analyzed according to the presence of anti-HBc. HBV serology results at the time of ASCT were compared with those at the time of diagnosis of MM or lymphoma.
RESULTS
Three patients (two anti-HBc-negative MMs and one anti-HBc-positive MM) developed HBV-related hepatitis after ASCT. The rate of HBV-related hepatitis did not differ among patients with or without anti-HBc status (p=0.843). HBV-related hepatitis more frequently occurred in MM patients than in lymphoma patients (p=0.041). Overall, 9.1% of patients (16.7% with MM and 5.4% with lymphoma) who were HBsAg-negative and anti-HBc-positive at the time of diagnosis had lost anti-HBc positivity during chemotherapy prior to ASCT.
CONCLUSION
Our data suggest that HBsAg-negative, anti-HBc-negative patients at the time of ASCT for MM or lymphoma still might be at a risk for HBV-related hepatitis.

Keyword

Hepatitis B core antibody; HBV-related hepatitis; Stem cell transplantation; Lymphoma; Multiple myeloma

MeSH Terms

Diagnosis
Drug Therapy
Hepatitis B Surface Antigens
Hepatitis B virus
Hepatitis B*
Hepatitis*
Humans
Lymphoma*
Multiple Myeloma*
Retrospective Studies
Stem Cell Transplantation*
Stem Cells*
Hepatitis B Surface Antigens

Figure

• 

  Fig. 1. The incidence of hepatitis and hepatitis B surface antigen (HBsAg) reversion in 271 HBsAg-negative patients within and more than 1 year after autologous stem cell transplantation without hepatitis B virus (HBV) prophylaxis. Anti-HBc, hepatitis B core antibody; Anti-HBs, hepatitis B surface antibody; ASCT, autologous stem cell transplantation.

• 

  Fig. 2. Changes in hepatitis B core antibody (anti-HBc) status (A) and hepatitis B surface antibody (anti-HBs) status (B) in hepatitis B surface antigen (HBsAg)–negative patients from diagnosis to transplantation. ASCT, autologous stem cell transplantation.

Reference

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