Hepatitis-associated aplastic anemia: Etiology, clinical characteristics and outcome

Creative Commons License

Tüfekçi Ö., Özdemir H. İ., Malbora B., Özbek N. Y., Yarali N., Erdem A., ...More

Journal of Pediatric Hematology/Oncology, vol.44, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 44
  • Publication Date: 2022
  • Doi Number: 10.1097/mph.0000000000002268
  • Journal Name: Journal of Pediatric Hematology/Oncology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, EMBASE, MEDLINE
  • Keywords: hepatitis-associated aplastic anemia, aplastic anemia, hepatitis, RABBIT ANTITHYMOCYTE GLOBULIN, PEDIATRIC-PATIENTS, CHILDREN, FAILURE
  • Dokuz Eylül University Affiliated: Yes


Copyright r 2021 Wolters Kluwer Health, Inc.Hepatitis-associated aplastic anemia (HAA) is a form of acquired aplastic anemia (AA) in which bone marrow failure develops after an acute attack of hepatitis. Bone marrow failure leading to AA is generally severe in cases of HAA and fatal if left untreated. This retrospective multicenter study investigated clinical and laboratory characteristics, possible causes, treatment, and outcome of HAA in children. Twenty patients from 8 centers were included in the study. Aspartate aminotransferase and alanine aminotransferase were <3 to 5×upper limit of normal (ULN) in 2 patients, <5 to 10×ULN in 2 patients, and >10×ULN in 16 patients. Acute liver failure developed in 5 (29%) patients. Pancytopenia was simultaneously present in 6 of 20 (30%) patients. Eleven of the 20 patients (55%) were alive, in remission and transfusion free. Those who were alive either had undergone hematopoietic stem cell transplantation and/or immunosuppressive treatment, except 1 patient who had received no treatment. Patients with the diagnosis of acute hepatitis should be evaluated and followed up carefully for presence of cytopenia, so that definitive treatment of AA can be initiated in a timely and appropriate manner when needed.