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 (SAAWP-EBMT)

TY - JOUR

T1 - 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 (SAAWP-EBMT)

AU - Mohseny, Alexander B

AU - Eikema, Dirk-Jan A

AU - Neven, Benedicte

AU - Kröger, Nicolaus

AU - Shaw, Peter J

AU - Damaj, Ghandi

AU - Dalle, Jean-Hugues

AU - Bosman, Paul V

AU - Delehaye, Fanny

AU - Lankester, Arjan C

AU - Smiers, Frans J

AU - Peffault de Latour, Regis

PY - 2021/10/1

Y1 - 2021/10/1

N2 - 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.

AB - 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.

KW - Adolescent

KW - Adult

KW - Anemia, Aplastic/etiology

KW - Child

KW - Child, Preschool

KW - Female

KW - Follow-Up Studies

KW - Hematopoietic Stem Cell Transplantation/methods

KW - Hepatitis/complications

KW - Humans

KW - Liver Transplantation/adverse effects

KW - Male

KW - Prognosis

KW - Retrospective Studies

KW - Societies, Medical

U2 - 10.1097/MPH.0000000000001991

DO - 10.1097/MPH.0000000000001991

M3 - SCORING: Review article

C2 - 33273414

VL - 43

SP - e1025-e1029

JO - J PEDIAT HEMATOL ONC

JF - J PEDIAT HEMATOL ONC

SN - 1077-4114

IS - 7

ER -