A PROSPECTIVE-STUDY ON THE INCIDENCE OF HEPATITIS-B AND HEPATITIS-C INFECTIONS AMONGST PATIENTS WITH LYMPHOPROLIFERATIVE DISORDERS

Fifty one patients with acute lymphoblastic leukaemia (ALL) and non-Ho dgkins lymphoma (NHL) undergoing chemotherapy were studied prospective ly to determine the incidence, aetiology and natural course of hepatit is. Of 51 patients (31 NHL and 20 ALL), 22 developed hepatitis. Hepati tis B (IgM anti HBc positive) was the cause in 11 patients (50%), hepa titis C in 4 patients, and septicaemia and cytotoxic drugs in 3 patien ts each. Malignant infiltration of the liver was the cause in the rema ining 1 patient, Hepatitis was predominantly (75%) anicteric. Mean dur ation of hepatitis was 21 days. Of 51 patients, 21 acquired hepatitis B and/or C virus infection. They had received 6.4 (+/-3.4) units of pa cked red cells anti 5.3 (+/-11) units of platelet concentrate as compa red to 3.4 (+/-4.8) units of red cells and 5.3 (+/-12.1) units of plat elet concentrate received by those who did not acquire virus infection (P<0.05 far packed red cells). Only transient stoppage of chemotherap y was necessary following development of hepatitis and most of the pat ients who developed hepatitis could complete their chemotherapy schedu le, None of the patients who developed viral B or C infection cleared the infection. We conclude that there was a high incidence of hepatiti s B and C infection amongst patients with lymphoproliferative disorder s with an increased carrier rate. Transfusion was a major risk factor for such infections.