Hematopoietic Stem Cell Transplantation for Hepatitis-associated Aplastic Anemia Following Liver Transplantation for Nonviral Hepatitis: A Retrospective Analysis and a Review of the Literature by the Severe Aplastic Anemia Working Party of the European Society for Blood and Marrow Transplantation. Issue 7 (2nd October 2021)

• Record Type: Journal Article
• Authors: Mohseny, Alexander B.; Eikema, Dirk-Jan A.; Neven, Benedicte; Kröger, Nicolaus; Shaw, Peter J.; Damaj, Ghandi; Dalle, Jean-Hugues; Bosman, Paul V.; Delehaye, Fanny; Lankester, Arjan C.; Smiers, Frans J.; Peffault de Latour, Regis
• Is Part Of: Journal of pediatric hematology/oncology. Volume 43:Issue 7(2021)
• Page Start: e1025
• Page End: e1029
• Publication Date: 2021-10-02
• Subjects: nonviral hepatitis -- acute liver failure -- liver transplantation -- aplastic anemia -- HSCT; Pediatric hematology -- Periodicals; Tumors in children -- Periodicals; 618.9215
• DOI: 10.1097/MPH.0000000000001991
• Languages: English
• ISSNs: 1077-4114

Abstract

Abstract : Hepatitis-associated aplastic anemia (HAAA) has been reported in 23% to 33% of patients who received orthotopic liver transplantation (LT) for acute liver disease of unknown origin (nonviral hepatitis). In this situation, hematopoietic stem cell transplantation (HSCT) might be a curative option. Here the authors report on 6 patients who received HSCT after LT for nonviral HAAA hepatitis. The outcomes were interpreted in the context of recently reported immune suppressive therapy (IST) outcomes in 8 patients with HAAA and to HSCT outcomes in patients with HAAA who recovered from hepatitis without undergoing LT. All patients transplanted by using HLA-identical sibling donors (3 of 6) were alive and had normal liver function and hematopoiesis without graft versus host disease. Both patients receiving bone marrow from a matched unrelated donor (MUD) experienced extensive graft versus host disease that was fatal for one patient. Thereby, the authors conclude that HSCT can be considered as a first-choice treatment for this category of patients when HLA-identical donors are available. When no HLA-identical donor is available, IST should be applied as HSCT with other donor sources might be reserved for IST nonresponders or poor responders.