الفهرس | Only 14 pages are availabe for public view |
Abstract ABSTRACT Background: hematopoietic stem cell transplantation (HSCT) is now established as a standard therapeutic modality for a variety of malignant and non-malignant diseases.HSCT had many possible serious complications. Infection and GVHD remain the major source of morbidity and mortality in patients who undergo BMT. Aim of the Work: The aim of this work is to investigate the impact hepatitis B (HBV) and hepatitis C (HCV) viral infection on the outcome of fully matched sibling donor (MSD) peripheral blood stem cell transplantation (PBSCT) in patients with Acute Myeloid Leukemia (AML). Patients and Methods: three hundred and Twenty Eight patients with Acute myeloid leukemia 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 period of at least 12 months. Results: In seropositive patients; Neutrophil engraftment was reached at a median of 14.57 days, Platelet engraftment was reached at a median of 12.7. While in seronegative patitients; Neutrophil engraftment was reached at a median of 14.3 (P-value 0.287), Platelet engraftment was reached at a median of 12.66 (P-value 0.917). In seropositive patients the incidence of SOS was 2.1%, Acute GVHD grade 2-4 was reported in 8 patients while chronic GVHD was reported in 9 patients. In seronegative patients, the incidence of SOS was 0.70% (P- value 0.33), Acute GVHD grade 2-4 was reported in 30 patients (P-value 0.184) while chronic GVHD was reported in 45 patients (P-value 0.54). Overall survival (OS) for HCV seronegative and seropositive patients was 58.4 % & 44.6 %, respectively (P-value= 0.001) while Disease free survival (DFS) for HCV seronegative and seropositive patients was 56.9 % & 43.4 %, respectively (P-value= 0.0001). Conclusion: Analysis of 46 HCV positive adult AML patients and 282 HCV seronegative patients subjected to PBSCT show that HCV does not affect platelet or neutrophil engraftment or the incidence of SOS. HCV viremia did not show a significant impact on the incidence of Acute and chronic Graft Versus Host Disease. We also documented that there is a significant impact of HCV on both the DFS and OS. |