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Cirrhosis of the liver in long-term marrow transplant survivors.

Publication ,  Journal Article
Strasser, SI; Sullivan, KM; Myerson, D; Spurgeon, CL; Storer, B; Schoch, HG; Murakami, CS; McDonald, GB
Published in: Blood
May 15, 1999

Patients who survive hematopoietic cell transplantation (HCT) have multiple risk factors for chronic liver disease, including hepatitis virus infection, iron overload, and chronic graft-versus-host disease (GVHD). We studied 3,721 patients who had survived 1 or more years after HCT at a single center and identified patients with histologic or clinical evidence of cirrhosis. Risk factors for the development of cirrhosis were evaluated and compared with a group of matched control subjects. Cirrhosis was identified in 31 of 3,721 patients surviving 1 or more years after HCT, 23 of 1,850 patients surviving 5 or more years, and in 19 of 860 patients surviving 10 or more years. Cumulative incidence after 10 years was estimated to be 0.6% and after 20 years was 3.8%. The median time from HCT to the diagnosis of cirrhosis was 10.1 years (range, 1.2 to 24.9 years). Twenty-three patients presented with complications of portal hypertension, and 1 presented with hepatocellular carcinoma. Thirteen patients have died from complications of liver disease, and 2 died of other causes. Three patients have undergone orthotopic liver transplantation. Hepatitis C virus infection was present in 25 of 31 (81%) of patients with cirrhosis and in 14 of 31 (45%) of controls (P =.01). Cirrhosis was attibutable to hepatitis C infection in 15 of 16 patients presenting more than 10 years after HCT. There was no difference in the prevalence of acute or chronic GVHD, duration of posttransplant immunosuppression, or posttransplant marrow iron stores between cases and controls. Cirrhosis is an important late complication of hematopoietic cell transplantation and in most cases is due to chronic hepatitis C. Long-term survivors should be evaluated for the presence of abnormal liver function and hepatitis virus infection.

Duke Scholars

Published In

Blood

ISSN

0006-4971

Publication Date

May 15, 1999

Volume

93

Issue

10

Start / End Page

3259 / 3266

Location

United States

Related Subject Headings

  • Time Factors
  • Survivors
  • Risk Factors
  • Retrospective Studies
  • Neoplasms
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Liver Cirrhosis
  • Infant
 

Citation

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MLA
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Strasser, S. I., Sullivan, K. M., Myerson, D., Spurgeon, C. L., Storer, B., Schoch, H. G., … McDonald, G. B. (1999). Cirrhosis of the liver in long-term marrow transplant survivors. Blood, 93(10), 3259–3266.
Strasser, S. I., K. M. Sullivan, D. Myerson, C. L. Spurgeon, B. Storer, H. G. Schoch, C. S. Murakami, and G. B. McDonald. “Cirrhosis of the liver in long-term marrow transplant survivors.Blood 93, no. 10 (May 15, 1999): 3259–66.
Strasser SI, Sullivan KM, Myerson D, Spurgeon CL, Storer B, Schoch HG, et al. Cirrhosis of the liver in long-term marrow transplant survivors. Blood. 1999 May 15;93(10):3259–66.
Strasser, S. I., et al. “Cirrhosis of the liver in long-term marrow transplant survivors.Blood, vol. 93, no. 10, May 1999, pp. 3259–66.
Strasser SI, Sullivan KM, Myerson D, Spurgeon CL, Storer B, Schoch HG, Murakami CS, McDonald GB. Cirrhosis of the liver in long-term marrow transplant survivors. Blood. 1999 May 15;93(10):3259–3266.

Published In

Blood

ISSN

0006-4971

Publication Date

May 15, 1999

Volume

93

Issue

10

Start / End Page

3259 / 3266

Location

United States

Related Subject Headings

  • Time Factors
  • Survivors
  • Risk Factors
  • Retrospective Studies
  • Neoplasms
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Liver Cirrhosis
  • Infant