Transfer of humoral and cellular hepatitis B immunity by allogeneic hematopoietic cell transplantation

2003 ◽  
Vol 75 (6) ◽  
pp. 833-838 ◽  
Author(s):  
Monika Lindemann ◽  
Vah?? Barsegian ◽  
Volker Runde ◽  
Melanie Fiedler ◽  
Klaus-Hinrich Heermann ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Allogeneic Hematopoietic Cell Transplantation

A case-controlled study on the use of HBsAg-positive donors for allogeneic hematopoietic cell transplantation

Blood ◽  
2000 ◽  
Vol 96 (2) ◽  
pp. 452-458 ◽  
Author(s):  
George K. K. Lau ◽  
Albert K. W. Lie ◽  
Yok Lam Kwong ◽  
Cheuk Kwong Lee ◽  
Jinlin Hou ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Core Promoter ◽  
Hematopoietic Cell ◽  
Allogeneic Hematopoietic Cell Transplantation ◽  
Controlled Study ◽  
Management Approach ◽  
Group 2 ◽  
Group 1

Abstract To compare the clinical and serological outcomes of patients receiving donors' marrow positive or negative for hepatitis B surface antigen (HBsAg), we studied 18 patients of allogeneic hematopoietic cell transplantation receiving HBsAg-positive marrow (group 1) and 18 receiving HBsAg-negative marrow (group 2). The recipients of the 2 groups were matched for hepatitis B virus (HBV) serology, sex, age, underlying hematological diseases, conditioning regimen, and prophylaxis against graft-versus-host diseases. Eight (44.4%) recipients in group 1 and 2 (11.1%) in group 2 suffered from HBV-related hepatitis posttransplant (P = .03). Furthermore, HBV-related hepatic failure was seen in 6 group 1 patients, but in none of the group 2 patients (P = .007). Five of the 9 (55.5%) HBsAg-negative recipients in group 1 became positive after receiving HBsAg-positive marrow. Serum HBV DNA was positive in all 5 donors of these patients, but in none of the donors of recipients who remained HBsAg negative (P = .008). Group 1 patients developing HBV-related hepatitis posttransplant were more likely to have a donor carrying a precore A1896 and/or core promoter T1762/A1764 HBV variant (62.5% versus 0%, P = .007). This study has demonstrated that a high incidence of HBV-related hepatitis was associated with the use of HBsAg-positive marrow for transplant, and a high viral load in the donor appeared to predispose recipients to the development of HBV-related hepatitis posttransplant. Further clinical trials will be necessary to determine the optimal management approach to this problem, including the use of the antiviral agents in the donors and the recipients.

scholarly journals Immune Status Against Hepatitis B in Patients After Allogeneic Hematopoietic Cell Transplantation—Factors Affecting Early and Long-Lasting Maintenance of Protective Anti-HBs Titers

2020 ◽  
Vol 11 ◽  
Author(s):  
Agnieszka Piekarska ◽  
Piotr Wisniewski ◽  
Krzysztof Lewandowski ◽  
Lidia Gil ◽  
Piotr Trzonkowski ◽  
...  
Keyword(s):  
T Cell ◽  
Hepatitis B ◽  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Hepatitis B Surface Antigen ◽  
Vaccination Schedule ◽  
Hematopoietic Cell ◽  
Allogeneic Hematopoietic Cell Transplantation ◽  
T Cell Subsets ◽  
Immunological Parameters

The immunization of allogeneic hematopoietic cell transplantation (HCT) recipients against vaccine-preventable diseases is a part of posttransplantation guidelines. We conducted a prospective study to assess clinical and immunological parameters that would determine the response and long-term maintenance of protective antibody titers upon the hepatitis B virus (HBV) vaccination after HCT. The investigated variables included: vaccination of the HCT recipients and their donors prior to HCT, chronic graft versus host disease (cGVHD) and the timing of post-HCT vaccination, and B- and T-cell subtype status. Forty-two patients were immunized with three or more doses of recombinant hepatitis B surface antigen (rHBsAg) administered according to the individualized schedule of 0-1-2-6-(12) months. After vaccination, seroconversion was achieved in the whole group. The vaccines were categorized according to the antibody (Ab) titers as weak (WRs; 28.7%), good (GRs; 38%) or very good responders (VGRs; 3.3%). In multivariate logistic regression, severe cGVHD (OR= 15.5), and preceding donor immunization (OR= 0.13) were independent predictors of a weak response to vaccination. A prior belonging to the WR group impaired the durability of protection (OR= 0.17) at a median follow-up of 11.5 years. Patients with severe cGVHD showed a trend toward lower median Ab titers, although they required a higher rate of booster vaccine doses. All VGRs had CD4+ cells > 0.2 x 106/L. There was a lower mean rate of CD4+IL2+ lymphocytes in WRs. Vaccination demonstrated the immunomodulatory effect on B-cell and T-cell subsets and a Th1/Th2 cytokine profile, while shifts depended on a history of severe cGVHD and the type of vaccine responder. To conclude, vaccination of HCT donors against HBV allows a better response to vaccination in the respective HCT recipients. Double doses of rHBsAg should be considered in patients with cGVHD and in those not immunized before HCT. A dedicated intensified vaccination schedule should be administered to WRs.

A case-controlled study on the use of HBsAg-positive donors for allogeneic hematopoietic cell transplantation

Blood ◽  
2000 ◽  
Vol 96 (2) ◽  
pp. 452-458 ◽  
Author(s):  
George K. K. Lau ◽  
Albert K. W. Lie ◽  
Yok Lam Kwong ◽  
Cheuk Kwong Lee ◽  
Jinlin Hou ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Core Promoter ◽  
Hematopoietic Cell ◽  
Allogeneic Hematopoietic Cell Transplantation ◽  
Controlled Study ◽  
Management Approach ◽  
Group 2 ◽  
Group 1

To compare the clinical and serological outcomes of patients receiving donors' marrow positive or negative for hepatitis B surface antigen (HBsAg), we studied 18 patients of allogeneic hematopoietic cell transplantation receiving HBsAg-positive marrow (group 1) and 18 receiving HBsAg-negative marrow (group 2). The recipients of the 2 groups were matched for hepatitis B virus (HBV) serology, sex, age, underlying hematological diseases, conditioning regimen, and prophylaxis against graft-versus-host diseases. Eight (44.4%) recipients in group 1 and 2 (11.1%) in group 2 suffered from HBV-related hepatitis posttransplant (P = .03). Furthermore, HBV-related hepatic failure was seen in 6 group 1 patients, but in none of the group 2 patients (P = .007). Five of the 9 (55.5%) HBsAg-negative recipients in group 1 became positive after receiving HBsAg-positive marrow. Serum HBV DNA was positive in all 5 donors of these patients, but in none of the donors of recipients who remained HBsAg negative (P = .008). Group 1 patients developing HBV-related hepatitis posttransplant were more likely to have a donor carrying a precore A1896 and/or core promoter T1762/A1764 HBV variant (62.5% versus 0%, P = .007). This study has demonstrated that a high incidence of HBV-related hepatitis was associated with the use of HBsAg-positive marrow for transplant, and a high viral load in the donor appeared to predispose recipients to the development of HBV-related hepatitis posttransplant. Further clinical trials will be necessary to determine the optimal management approach to this problem, including the use of the antiviral agents in the donors and the recipients.

Sign in / Sign up

Export Citation Format

Share Document