Pb2419: the outcome of viral hepatitis-c infection on hematological malignancies after autologous bone marrow transplantation in egypt

Topic: 22. Stem cell transplantation - Clinical Background: Autologous bone marrow transplantation (ABMT) is the cornerstone of many hematological disorders. HCV-infected patients who undergo ABMT are at risk for a variety of HCV infection-related complications. Furthermore, acute exacerbation may occur during and after transplantation. Hence, the need for studies on the impact of HCV on ABMT is imperative. Aims: The primary objective of this study is to determine the outcome of HCV patients with hematological malignancies after ABMT, including toxicity and disease-free survival (DFS). The secondary objective is to identify if there is a difference in overall survival (OS) between HCV-positive and negative patients after ABMT. Methods: This is a retrospective study that included 100 HCV positive patients with hematological malignancies (lymphoma and myeloma) who received ABMT compared to cross matched 100 HCV negative patients based on age, gender, and disease status at transplant. They were attending the outpatient clinics for follow up in Nasser Institute and Sheikh Zayed Specialized Hospital, Egypt. Acute exacerbation of chronic HCV infection is defined as ≥ 3-fold increase in basal ALT level without recent history of blood transfusion, infection, hepatic infiltration, or use of hepatotoxic drugs. Results: This study showed that the mean age of patients was 44.5 (± 12.5) years. They were 154 males and 46 females. The most common reasons for ABMT were multiple myeloma (40%), non-hodgkin lymphoma (33.5%), and hodgkin lymphoma (26.5%). There was a significant increase in the frequency of NHL among the HCV-positive group (p 0.007). Pre-transplant AST and ALT levels were significantly higher in the HCV-positive group than in the HCV-negative group (p 0.001 and 0.001, respectively). There were significant differences in the post-transplant outcome regarding serum bilirubin level and the incidence of acute exacerbation between the HCV- positive and HCV- negative study groups (p 0.044 and 0.049, respectively). The HCV-positive group received a significantly higher number of platelet units transfusion than those in the HCV-negative group (p 0.001). The median duration of hospital stay was significantly prolonged in the HCV-positive group compared to the HCV-negative group (p 0.024). DFS was significantly shorter in HCV-infected individuals (p 0.048), while OS was comparable between both groups (P 0.259). Summary/Conclusion: We concluded that, while the HCV-negative arm had a better result than the positive arm, HCV positivity is not a contraindication to ABMT. Keywords: Hepatitis C virus, Multiple myeloma, Autologous bone marrow transplant, Lymphoma