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Outcome of anti-thymocyte immunoglobulin plus cyclosporine A for severe aplastic anaemia with chronic hepatitis B virus infection

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Abstract

The influence of chronic hepatitis B virus (HBV) infection on the efficacy of intensive immunosuppressive treatment (IST) of severe aplastic anaemia (SAA) patients remains unclear. Previous reports on this topic have been mostly case reports or have had a relatively short follow-up. Eight SAA patients carrying chronic HBV infection and 24 matched patients without HBV at a ratio of 1:3 were included in this retrospective analysis. The patients were treated with anti-thymocyte globulin (ATG) and cyclosporine A. Entecavir was or was not administered throughout the IST course to patients with positive or negative HBV-DNA results, respectively. No evident HBV reactivation developed. The overall response was 87.5% by 12 months, and the recurrence rate was 12.5%. There were no significant differences in overall response, overall survival and event-free survival between groups. Entecavir can effectively prevent reactivation of HBV in SAA patients with positive HBV-DNA who received intensive IST. Regular surveillance may be sufficient for HBV-DNA negative patients who should receive antiviral drugs immediately when their HBV-DNA status changes from negative to positive. The prognosis of SAA patients with chronic HBV infection after intensive IST treatment is not worse than those without HBV infection.

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Acknowledgements

Thanks are due to Chao Liu and Xinhui Qiao for the valuable discussions and assistance with the statistical analysis.

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Authors and Affiliations

  1. Department of Hematology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 100730, China

    Miao Chen, Junling Zhuang, Daobin Zhou, Ying Xu, Yongqiang Zhao, Shujie Wang, Wei Zhang, Minghui Duan, Tienan Zhu, Jian Li, Huacong Cai, Xinxin Cao & Bing Han

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  1. Miao Chen
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  2. Junling Zhuang
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  3. Daobin Zhou
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  4. Ying Xu
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  5. Yongqiang Zhao
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  6. Shujie Wang
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  7. Wei Zhang
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  9. Tienan Zhu
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  10. Jian Li
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  11. Huacong Cai
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  12. Xinxin Cao
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  13. Bing Han
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Corresponding author

Correspondence to Bing Han.

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All procedures followed were in accordance with the ethical standards of the Ethics Committee of Peking Union Medical College Hospital and with the Helsinki Declaration of 1975, as revised in 2008. Patient information was anonymized and de-identified prior to analysis.

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The authors declare that they have no conflicts of interest.

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Chen, M., Zhuang, J., Zhou, D. et al. Outcome of anti-thymocyte immunoglobulin plus cyclosporine A for severe aplastic anaemia with chronic hepatitis B virus infection. Ann Hematol 96, 581–587 (2017). https://doi.org/10.1007/s00277-017-2918-9

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  • DOI: https://doi.org/10.1007/s00277-017-2918-9

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