Fulminant hepatitis is significantly increased in hepatitis B carriers after allogeneic bone marrow transplantation

Po Min Chen, Tzeon Jye Chiou, Frank S. Fan, Jacqueline Ming Liu, Ruey Kuen Hsieh, Chueh Chuan Yen, Wei Shu Wang, Jin Hwang Liu

Research output: Contribution to journalArticlepeer-review

31 Citations (Scopus)


Background. Bone marrow transplantation (BMT) is effective treatment for many hematologic disease, but performed in a population with a high endemic hepatitis B virus carrier rate, the incidence of liver function impairment and fulminant hepatitis (FH) is expected to be raised. Methods. Forty-three hepatitis B virus carriers received high-dose chemotherapy and BMT, 32 patients received an allogeneic graft, and 11 patients autologous marrow. Acute graft-versus-host disease prophylaxis consisted of methotrexate on day 1, 3, 6, and 11 and cyclosporine for 6 months. Results. After a median follow-up period of 68 months (range: 1-11.5 years), 26 (81.3%) allogeneic BMT patients developed impaired liver function (LF), 5 progressed to FH on day 93, 169, 170, 180, and 468, respectively, and died after an average of 13.8 days (range: 1-45 days). Whereas only 4 (36.4%) autologous BMT patients developed impaired LF, and none FH. Impaired LF (P=0.026, chi-square), and FH (odds ratio=12.86, P=0.009 for coefficient) were significantly related to an allogeneic marrow graft, and the timing of liver function impairment coincided with cyclosporine withdrawal. Hepatitis B surface antigen (HbsAg) disappeared from the serum in 4/14(28.6%) patients receiving a marrow graft from an HbsAg+ donor. HbsAg was not detected in the serum after BMT in 2/11 (18.2%) autologous BMT patients. Conclusions. Hepatitis B virus carriers receiving a marrow graft from an HbsAg+ donor have a significantly increased risk of FH.

Original languageEnglish
Pages (from-to)1425-1433
Number of pages9
Issue number11
Publication statusPublished - Jun 1999
Externally publishedYes

ASJC Scopus subject areas

  • Transplantation


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