Peffault de Latour R, Asselah T, Lévy V, Scieux C, Devergie A, Ribaud P, Espérou H, Traineau R, Gluckman E, Valla D, Marcellin P, Socié G
Service d'Hématologie - Greffe de Moelle Osseuse, et Université Paris VII, Hôpital Saint Louis, Paris Cedex, France.
Bone Marrow Transplant. 2005 Oct;36(8):709-13. doi: 10.1038/sj.bmt.1705120.
We recently reported an increased incidence of cirrhosis in hepatitis C virus (HCV)-infected stem cell transplant (SCT) recipients. Here, we describe our experience in the treatment of these patients, which has been, to date, poorly reported in the literature. Among 99 HCV-infected HCT recipients, 36 had HCV-related liver lesions on biopsy requiring therapy. Owing to HCV treatment contraindications, only 61% of patients (22/36) could be treated. In all, 12 patients received more than one course of anti-HCV treatment if they had HCV RNA still detectable after the first course of treatment and no treatment contraindications. Combined therapy (pegylated interferon (IFN): n=9, or standard IFN: n=9, in combination with ribavirin) led to sustained virological response in 4/18 (20%) patients as compared to 2/20 (10%) in patients who received IFN alone. Hematological toxicity was more frequent with combined therapy. While anemia responded to erythropoietin and/or dose modification, thrombocytopenia usually led to treatment interruption (n=3). This study thus highlights the efficacy of combined therapy and emphasizes the fact that the undue safety concerns are not a problem when treating this particular population.
