PB1856 HEPATITIS ASSOCIATED APLASTIC ANEMIA: ETIOLOGY, CLINICAL CHARACTERISTICS AND OUTCOME
Bildiriler > Özet Bildiri
Yazarlar: Ö. Tüfekçi, HAMİYET HEKİMCİ ÖZDEMİR, B. Malbora, N.Y. Özbek, N. Yaralı, A. Erdem, M. Evim, B. Baytan, T. Karapınar, Y. Oymak, S. Yılmaz, Deniz YILMAZ KARAPINAR
HemaSphere, , , Uluslararası, Özet Bildiri, Scopus, cilt 3, ss 846-847
DOI: 10.1097/01.hs9.0000565928.03711.c7
Özet
Background: Hepatitis associated aplastic anemia (HAA); is a form of acquired aplastic anemia in which bone marrow failure develops after an acute attack of hepatitis. Aplastic anemia can also be seen after liver transplantation due to acute fulminant hepatitis. Aims: In this study, we aimed to define clinical and labarotory characteristics, possible causes, treatment strategies and and clinical outcome in patients with HAA. Methods: Seventeen children from six centers throughout Turkey were enrolled in the study. Clinical data were retrieved from the medical records. Results: The median age at time of diagnosis of acute hepatisis was 8.9 years (min: 5‐max:17). Search for etiology revealed highly positive CMV‐DNA in one patient and HCV‐RNA in one patient. One other patient was found to be positive for EBV, CMV and parvovirus DNA. Besides, one patient had the diagnosis of autoimmune hepatitis. The median time from diagnosis of hepatitis to diagnosis of aplastic anemia was 30 days (min:0‐max:322). Pancytopenia was simultaneously present in 5 out of 17 (29%) patients. Liver transplantation due to acute fulminant hepatitis was performed in 5 patients (29%). Aplastic anemia developed before liver transplantation in two patients and after liver transplantation in three patients. In terms of treatment for aplastic anemia; 8 patients (47%) received immunsuppressive treatment (IST) with anti‐thymocyte globulin and cyclosporine. HLA identical hematopetic stem cell transplantation (HSCT) was performed in 5 patients (29%). Two patients who received IST later underwent HSCT. The median time from diagnosis of AA to IST and HSCT were 45 days (min:1‐max:218) and 104 days (min:86‐max:1282), respectively. At the end; 9 out of 17 patients (52%) were alive, in remission and transfusion free. Those who were alive either received HSCT and/or IST, except one patient who received no treatment. Eight patients (48%) died mainly due to infectious causes. Summary/Conclusion: Although there have been limited number of patients in the present study, it was noteworthy that approximately one‐third of patients presented with pancytopenia at the time of diagnosis of hepatitis. Further research is needed to investigate the effect of some etiological agents on the clinical outcome. The loss of patients who did not undergo IST and HSCT revealed once again the importance of initiating IST at the appropriate time together with donor search for HSCT in this group of patients.