Abstract
An 8-year-old Japanese girl with severe aplastic anemia who did not respond to immunosuppressive therapy underwent allogeneic bone marrow transplantation (BMT) from her HBsAg-positive HLA-identical brother. To decrease his serum HBV-DNA level, lamivudine was administered to him 7 weeks before bone marrow harvest. The pretransplant conditioning regimen consisted of cyclophosphamide and anti-thymocyte globulin, and bone marrow cells (3.38 × 108 cells/kg) were then infused after plasma depletion. In order to neutralize HBV with anti-HbsAb, HB immune globulin was infused on days 0, 1 and 2. The clinical course was uneventful, and hematological recovery occurred rapidly. Her HBsAg status remained persistently negative throughout the posttransplant periods, indicating that HBV has not been transmitted to her. Lamivudine administration to the HBsAg-positive bone marrow donor may be useful to prevent HBV infection.
