scholarly journals Clinical Profile and Outcomes of Patients With â Thalassemia Major and Hepatitis C Virus Infection Undergoing an Allogeneic Stem Cell Transplant

2013 ◽  
Vol 19 (2) ◽  
pp. S162-S163
Author(s):  
Vikram Mathews ◽  
Biju George ◽  
Kavitha Lakshmi ◽  
Aby Abraham ◽  
Rayaz Ahmed ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
Stem Cell Transplant ◽  
Thalassemia Major ◽  
Clinical Profile ◽  
Cell Transplant ◽  
Allogeneic Stem Cell Transplant ◽  
Hepatitis C Virus Infection

Prevalence of occult hepatitis C virus infection in Iranian patients with beta thalassemia major

2016 ◽  
Vol 161 (7) ◽  
pp. 1899-1906 ◽  
Author(s):  
Mohammad-Navid Bastani ◽  
Farah Bokharaei-Salim ◽  
Hossein Keyvani ◽  
Maryam Esghaei ◽  
Seyed Hamidreza Monavari ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Hepatitis C Virus Infection ◽  
Occult Hepatitis ◽  
Beta Thalassemia Major ◽  
Occult Hepatitis C ◽  
Iranian Patients

scholarly journals Modulating Innate Immunity Improves Hepatitis C Virus Infection and Replication in Stem Cell-Derived Hepatocytes

2014 ◽  
Vol 3 (1) ◽  
pp. 204-214 ◽  
Author(s):  
Xiaoling Zhou ◽  
Pingnan Sun ◽  
Baltasar Lucendo-Villarin ◽  
Allan G.N. Angus ◽  
Dagmara Szkolnicka ◽  
...  
Keyword(s):  
Innate Immunity ◽  
Stem Cell ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
Hepatitis C Virus Infection

scholarly journals Prevalence of Occult Hepatitis C Virus Infection in Beta-Thalassemia Major Patients in Ahvaz, Iran

2021 ◽  
Author(s):  
sepideh Nasimzadeh ◽  
azarakhsh azaran ◽  
shahram Jalilian ◽  
Manoochehr Makvandi ◽  
Seyed Saeid Seyedian ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Hcv Rna ◽  
Hepatitis C Virus Infection ◽  
Occult Hepatitis ◽  
Beta Thalassemia Major ◽  
Occult Hepatitis C

Abstract Background: Occult hepatitis C virus infection (OCI) is defined by the presence of HCV RNA in peripheral blood mononuclear cells (PBMCs) and liver tissue cells despite the absence of HCV RNA in plasma. Currently, OCI is classified into two types: seropositive OCI (anti-HCV positive and serum HCV-RNA negative) and seronegative OCI (anti-HCV and serum HCV-RNA negative). Beta-Thalassemia is described as a blood disorder, which decreases the synthesis of hemoglobin. Repeated blood transfusion is the standard treatment for patients with beta-thalassemia major (BTM) that increases the risk of exposure to infectious agents. This study aimed to investigate the prevalence of OCI among BTM patients.Materials and Methods: plasma and PBMCs were collected from 90 BTM patients and screened for HCV antibody using the ELISA kit commercially as the first step. Then nested-RT PCR was performed on extractions of plasma and PBMC. Positive samples of HCV RNA from PBMCs were sequenced and aligned to construct the HCV phylogenetic tree to assess the homology of sequences compared to the reference sequences retrieved from GenBank.Results: Seventy-nine out of 90 cases (87.8%) indicated negative results for HCV Ab (seronegative), while 11 patients (12.2%) were seropositive. HCV RNA was found in PBMCs samples of four patients (66.66%) with negative HCV Ab (seronegative) and two patients (33.3%) with positive HCV Ab (seropositive). HCV RNA was not detected in plasma samples of these six patients. Overall six out of 90 patients (6.7%) had OCI. HCV genotyping revealed that all six patients infected with HCV subtype 3a.Conclusion: We indicated the high frequency of OCI in BTM patients. Nevertheless, more attention is warranted, considering the importance of this infection. Also, further studies are necessary to determine the actual prevalence of OCI among BTM patients in Iran.

Clinical Profile and Outcome Of Patients With Graft Rejection Following Related HLA Matched Allogeneic Stem Cell Transplant For β Thalassemia Major

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4546-4546
Author(s):  
Vikram Mathews ◽  
Abhijeet Ganapule ◽  
Biju George ◽  
Kavitha M Lakshmi ◽  
Aby Abraham ◽  
...  
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Median Time ◽  
Graft Rejection ◽  
Graft Failure ◽  
Stem Cell Transplant ◽  
Conditioning Regimen ◽  
Thalassemia Major ◽  
Cell Transplant ◽  
Allogeneic Stem Cell Transplant

Allogeneic stem cell transplant (SCT) remains the only curative option for patients with β thalassemia major (TM). Graft rejections post SCT are unfortunately a common problem in this condition. There is limited data on the clinical profile and long term outcome of patients who have had a graft rejection post allogeneic SCT. We undertook a retrospective analysis of patients who had a graft failure post allogeneic SCT for TM at our center. From October, 1991 to April, 2013, 400 HLA matched related transplants for TM was done at our center. The median age was 8 years (range: 1-24) and there were 250 (62.5%) males. 154 (38.5%) were Lucarelli Class II and 229 (57.2%) were in the Class III risk group. Majority (72%) received a busulfan based conditioning regimen while 22% received a treosulfan based regimen. Bone marrow was the source of stem cells in 81% and PBSC in the rest. Majority of the patients received a CSA plus short course methotrexate GVHD prophylaxis regimen. There were 48 (12%) graft rejections in this cohort. Among these 26 (54%) were primary graft failures (PGF) while 22 (46%) were secondary graft failures (SGF). The median time to a secondary graft failure was 122 days (range: 40 - 2210). Of the 26 PGF, 9(34.6%) had autologous recovery with recurrence of transfusion dependence while 17(65.4%) had pancytopenia. 11 (42.3%) of PGF died prior to second transplant, 10 had a second transplant and 3(11.53%) had recurrence of TM but were alive and well. Among the 22 SGF, 10(45.5%) had autologous recovery. Of the SGF, 2 died prior to a second transplant while 9 had a second transplant and the remaining (n=11) had recurrence of TM and were on conservative management. Among the 29 cases that did not receive a second transplant 14 died at a median time of 20 days from date of documented rejection (range: 0-3268). The major cause of death in this group was graft failure with infection (n=10) and regimen related toxicity (RRT; N=4). Of the remaining cases, 14 have recurrent TM and are alive and well on conservative management while one patient is alive with pancytopenia and is transfusion dependent. 19 (39%) of the patients with graft rejection underwent a second allogeneic SCT. The median time from graft rejection to second transplant was 6 months (range: 0-42). Conditioning regimen for second SCT was busulfan based in 5 (26.3%), treosulfan based in 5 (26.3%) and the remaining received non-myeloablative conditioning regimens (fludarabine based, low dose TBI, OKT3, Cy-OKT3) in view of pancytopenia. The source of stem cells was BM in 7(36.84%) and PBSC in the rest. All cases conditioned with treosulfan based regimen received a PBSC graft. The OS and EFS of the patients that had a second transplant was 41.4±12.8% and 37.6±12.2% respectively. None of the patients conditioned with a treosulfan based regimen died or had a second graft rejection (data summarized in table 1). Of the remaining 14 patients 11 died of second graft rejection while 3 (all busulfan based conditioning) are alive and well at 3, 23 and 81 months from second transplant.Table 1Clinical profile and outcome of patients with graft rejections who underwent a second allogeneic SCT with a treosulfan based conditioning regimen and PBSC graft. All patients engrafted and are alive and transfusions independent at last follow upSerial NoAge (years)SexLiver size (cms)Lucarelli ClassStem cell dose (x10E6/kg)Acute GVHDChronic GVHDLast follow up (mths)17M2310.34NILYes10.422M4213.7NILNIL3.635M4310NILNIL3.6418M2310Grade 4NIL4.9518M13315NILNIL2.9 In conclusion graft rejection following allogeneic SCT for patients with TM are associated with poor clinical outcomes. Following a second transplant there is a high incidence of deaths due second graft rejection and infections. A treosulfan based reduced toxicity myeloablative regimen with a PBSC graft has potential to significantly improve the outcome in this group of patients. Disclosures: No relevant conflicts of interest to declare.

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