A PATIENT WITH ACUTE MYELOID LEUKEMIA WHO BECAME HB ANTIGEN- AND HBV-POSITIVE SIX MONTHS AFTER PLATELET TRANSFUSION: A CASE REPORT

Abstract

A 65-year-old male patient was admitted to the Jikei Daisan Hospital due to leukocytosis, anemia, and thrombocytopenia. He was diagnosed as having Philadelphia-positive acute myeloid leukemia. He was negative for hepatitis B surface antigen (HBsAg), HBs antibody, and HB core antibody before transfusion. On day 3 of hospitalization, he was transfused with platelets. The transfusion product was confirmed negative on the quadrivalent nucleic acid amplification test (NAT), conducted as pre-transfusion screening. The donor was positive for NAT two weeks later at the time of re-donation, but retrospective survey was not done due to a negative result for additional hepatitis B virus (HBV) DNA. However, the donor was found positive for HBVDNA one month after re-donation. Case review revealed that the patient had received the product, which had been collected during the window period. Monitoring for both HBsAg and HBVDNA every three to six weeks was required. Although HBVDNA was negative on day 44, 84, and 129 after hospitalization, he became positive for HBsAg and HBVDNA six months after transfusion, on day 149. HBVDNA sequence between the patient and donor were matched, confirming post-transfusion HBV infection. Preemptive therapy with entecavir prevented the development of acute hepatitis, and his HBVDNA status became negative.