Hepatitis B virus infection status is an independent risk factor for multiple myeloma patients after autologous hematopoietic stem cell transplantation

Tumour Biol. 2013 Jun;34(3):1723-8. doi: 10.1007/s13277-013-0709-z. Epub 2013 Feb 23.

Abstract

The purposes of this study were to evaluate the infection by hepatitis B virus (HBV) and its impact on survival and to provide a clinical reference for monitoring and treating HBV during and after autologous hematopoietic stem cell transplantation (ASCT) in patients with multiple myeloma (MM). A retrospective analysis of HBV infections was performed in 70 MM patients who received a sequential bortezomib-containing induction therapy and ASCT in our department from June 2006 to February 2012. Among the 70 patients in our study, 11 cases (15.7 %) were hepatitis B surface antigen positive (HBsAg+), and 23 cases (33.3 %) were hepatitis B core antibody positive (HBcAb+). Eight cases were HBsAg, hepatitis B e antibody (HBeAb), and HBcAb positive, while one case was HBsAg, hepatitis B e antigen (HBeAg), and HBcAb positive. The median follow-up times for the HBsAg+ group and the HBsAg-negative (HBsAg-) group were 27.0 (7.6-85.2) months and 28.7 (7.1-111.0) months, respectively. The 1-year, 2-year, and 3-year overall survival rates of the HBsAg+ group were 90.9, 80.8, and 34.6 %, respectively, and the median survival time was 31.2 months (95 % CI, 24.8-37.6). The 1-year, 2-year, and 3-year overall survival rates of the HBsAg- group were 98.2, 94, and 84.6 %, respectively, while the median survival time was not yet available. There was a statistically significant difference (p=0.008) in the overall survival rate between the two groups. By Cox regression analysis, we found that the HBsAg+ status was a prognostic factor, which could independently influence the overall survival rate for ASCT. In conclusion, the HBsAg+ status is an independent risk factor for patients with MM receiving ASCT. The application of standard antiviral treatment might help to overcome this risk factor.

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents / therapeutic use
  • DNA, Viral / genetics
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Follow-Up Studies
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hepatitis B / diagnosis
  • Hepatitis B / drug therapy
  • Hepatitis B / etiology*
  • Hepatitis B / mortality
  • Hepatitis B Antibodies / blood*
  • Hepatitis B Surface Antigens / metabolism*
  • Hepatitis B virus / physiology*
  • Humans
  • Male
  • Middle Aged
  • Multiple Myeloma / complications
  • Multiple Myeloma / therapy*
  • Multiple Myeloma / virology
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Transplantation, Autologous
  • Virus Activation / physiology*

Substances

  • Antiviral Agents
  • DNA, Viral
  • Hepatitis B Antibodies
  • Hepatitis B Surface Antigens