Partial splenic artery embolization (PSE) in a patient with grey platelet syndrome (GPS): a case report

Background

Grey platelet syndrome (GPS) is a rare cause of mild-to-severe bleeding. Up till now, there has been no definite treatment for GPS.

Case presentation

We reported a case diagnosed as GPS and presented with menorrhagia, metrorrhagia, gingival bleeding, and left hypochondrial pain. The platelet count was 18 thousand/cmm. Ultrasound splenic diameter was 22.0 cm. The multidisciplinary team decided to perform splenectomy; however, the patient was unfit for surgery. Partial splenic artery embolization (PSE) was performed. Follow-up after 24 months showed a normal menstrual cycle and absent pain. Platelet count rise to 70, 55, and 51 thousand/cmm after 1, 12, and 24 months, respectively. Splenic diameter showed a significant decrease to 11.2 cm after 24 months.

Conclusion

PSE is effective and safe in symptomatic patients with GPS.

Combined therapy with conventional trans-arterial chemoembolization (cTACE) and microwave ablation (MWA) for hepatocellular carcinoma >3-<5 cm

PURPOSE

To compare safety and efficacy of combined therapy with conventional transarterial chemoembolization (cTACE)+microwave ablation (MWA) versus only TACE or MWA for treatment of hepatocellular carcinoma (HCC) >3-<5 cm.

METHODS

This randomized controlled trial (NCT04721470) screened 278 patients with HCC >3-<5 cm. Patients were randomized into three groups: 90 underwent TACE (Group 1); 95 underwent MWA (Group 2); and 93 underwent combined therapy (Group 3). Patients were followed-up with contrast-enhanced CT or MRI. Images were evaluated and compared for treatment response and adverse events based on modified response evaluation criteria in solid tumor. Serum alpha-fetoprotein (AFP) concentration was measured at baseline and during every follow-up visit.

RESULTS

Final analysis included 265 patients (154 men, 111 women; mean age = 54.5 ± 11.8 years; range = 38-76 years). Complete response was achieved by 86.5% of patients who received combined therapy compared with 54.8% with only TACE and 56.5% with only MWA (p = 0.0002). The recurrence rate after 12 months was significantly lower in Group 3 (22.47%) than Groups 1 (60.7%) and 2 (51.1%) (p = 0.0001). The overall survival rate (three years after therapy) was significantly higher in Group 3 (69.6%) than Groups 1 (54.7%) and 2 (54.3%) (p = 0.02). The mean progression-free survival was significantly higher in Group 3 than groups 1 and 2 (p < 0.001). A decrease in AFP concentration was seen in 75%, 63%, and 48% patients of Group 3, 2, and 1, respectively.

CONCLUSIONS

Combined therapy with cTACE + MWA is safe, well-tolerated, and more effective than TACE or MWA alone for treatment of HCC >3-<5 cm.

Abstract PD3-06: Neratinib + fulvestrant for HER2-mutant, HR-positive, metastatic breast cancer: Updated results from the phase 2 SUMMIT trial

Background: HER2 mutations define a rare subset of metastatic breast cancer (MBC) with a unique mechanism of oncogenic addiction to HER2 signaling. Neratinib, an irreversible pan-HER tyrosine kinase inhibitor, has demonstrated single-agent clinical activity in HER2-mutant MBC. In HER2-mutant, HR+ MBC, neratinib + fulvestrant (N+F) appears synergistic vs single-agent neratinib, possibly due to more complete inhibition of bi-directional signaling between HER2 and estrogen receptors. Here we describe interim efficacy results of the expanded HER2-mutant, HR+ MBC cohort treated with N+F from SUMMIT (NCT01953926).

Methods: HR+ MBC patients (pts) with HER2 mutations documented by local testing received oral neratinib 240mg qd and intramuscular fulvestrant (labeled dose). Intensive loperamide prophylaxis was mandatory during cycle 1. Efficacy endpoints include objective response rate at week 8 (ORR8); confirmed objective response rate (ORR); clinical benefit rate (CBR); duration of response (DOR); progression-free survival (PFS); response was assessed by RECIST 1.1 and/or PET Response Criteria. Genomic profiling from fresh/archival tumor tissues and/or plasma cfDNA was performed retrospectively by next-generation sequencing (MSK-IMPACT).

Results: As of 18 May 2018, 46 HER2-mutant HR+ MBC pts have been treated with N+F. Most pts were pretreated, with 91% having received prior anti-cancer medication for MBC (range 0–10). ORR was 33% and median DOR in the 15 pts with a confirmed response was 9.2 months (95% CI 3.9–18.5). Twenty-four pts had prior fulvestrant exposure, and 19 had received prior CDK4/6i-based therapy. Clinical activity was observed with ORRs of 17% and 26% in prior fulvestrant-treated and prior CDK4/6i-treated pts, respectively. ORRs by HER2 mutation were: V777L 63% (5/8 pts); S310F/Y 67% (4/6 pts); G778_P780dup 50% (3/6 pts). Diarrhea was the most common adverse event (grade 3, 24%; grade 4, 0%). Median cumulative duration of grade 3 diarrhea was 3 days. There were no treatment discontinuations due to diarrhea.

 Neratinib + fulvestrantOutcomeaAll patients (N=46)Prior fulvestrant (N=24)Prior CDK4/6i-based therapy (N=19)ORR8 – n (%)19 (41.3)8 (33.3)7 (36.8)95% CI27.0–56.815.6–55.316.3–61.6ORR – n (%)15 (32.6)4 (16.7)5 (26.3)95% CI19.5–48.04.7–37.49.1–51.2DOR for each responder, months 5.6b; 9.2; 9.6b; 18.55.6b; 5.7b; 9.3; 9.6b; 12.9bCBR – n (%)27 (58.7)11 (45.8)9 (47.4)95% CI43.2–73.025.6–67.224.4–71.1Median (95% CI) time to event,c monthsPFS3.9 (3.6–5.7)3.7 (3.5–12.8)3.9 (1.9–NA)DOR9.2 (3.9–18.5)NANAaFor pts with both RECIST- and PET-evaluable lesions, the best of either RECIST or PET response was used to determine response; the earliest progression by RECIST or PET was used for progression; bPt has not progressed; cKaplan-Meier analysis; NA, not applicable

Conclusions: N+F demonstrates encouraging clinical activity with durable responses in heavily pretreated pts with HER2-mutant, HR+ MBC. Of note, responses were observed in pts who had received prior fulvestrant or CDK4/6 inhibitors. No new safety signals were identified; the rate of diarrhea was similar to single-agent neratinib and not dose limiting. Updated data after additional follow-up and genomic data will be presented.

Citation Format: Smyth LM, Piha-Paul SA, Saura C, Loi S, Lu J, Shapiro GI, Juric D, Mayer IA, Arteaga C, de la Fuente M, Brufksy AM, Mau-Sørensen M, Arnedos M, Moreno V, Sohn J-H, Schwartzberg L, Gonzàlez-Farré X, Cervantes A, Mann G, Shahin S, Cutler, Jr. RE, Eli LD, Xu F, Bagulho T, Lalani AS, Bryce R, Solit DB, Hyman DM, Meric-Bernstam F, Baselga J. Neratinib + fulvestrant for HER2-mutant, HR-positive, metastatic breast cancer: Updated results from the phase 2 SUMMIT trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD3-06.

Heteroclinic dynamics of coupled semiconductor lasers with optoelectronic feedback

Generalized Lotka-Volterra (GLV) equations are important equations used in various areas of science to describe competitive dynamics among a population of N interacting nodes in a network topology. In this Letter, we introduce a photonic network consisting of three optoelectronically cross-coupled semiconductor lasers to realize a GLV model. In such a network, the interaction of intensity and carrier inversion rates, as well as phases of laser oscillator nodes, result in various dynamics. We study the influence of asymmetric coupling strength and frequency detuning between semiconductor lasers and show that inhibitory asymmetric coupling is required to achieve consecutive amplitude oscillations of the laser nodes. These studies were motivated primarily by the dynamical models used to model brain cognitive activities and their correspondence with dynamics obtained among coupled laser oscillators.

A randomized double-blind phase II study to evaluate same-day vs next-day administration of pegfilgrastim with carboplatin and docetaxel in patients with NSCLC

7110

Background: Combination therapy with carboplatin and docetaxel has demonstrated activity against non-small cell lung cancer (NSCLC), but is associated with at least a moderate risk of febrile neutropenia (FN). Though pegfilgrastim is given only once-per-cycle 24 hours after chemotherapy (CT), administering pegfilgrastim on the same day as CT would be convenient for patients (pts). Methods: Pts ≥18 years with previously untreated stage IIIB or IV NSCLC and ECOG ≤2 who were candidates for carboplatin AUC 6 and docetaxel 75 mg/m2 were randomized 1:1 to receive pegfilgrastim 6 mg within 4 hours or approximately 24 hours after CT. The primary endpoint was the duration of grade 4 neutropenia (DSN) in cycle 1. Same-day administration was considered noninferior to next-day if the upper 95% confidence interval (CI) limit for the difference in DSN between groups in cycle 1 was <2 days. Results: As planned, 90 pts were enrolled. 88 pts received blinded study drug. Pts in the same-day and next-day groups had comparable mean baseline ANC and similar proportions of pts completed the study (43% vs 45%). In cycle 1, only 5% of pts in both groups experienced grade 4 neutropenia; resulting in a mean DSN of 0 days. Similarly in cycle 4, 10% (lasting for 1 day only) and 0% of pts in the same-day and next-day groups experienced grade 4 neutropenia. No pts experienced FN during the study. 44% of pts in the same-day and 33% of pts in the next-day group experienced serious adverse events. Conclusions: In this study of lung cancer patients receiving carboplatin and docetaxel, use of pegfilgrastim from the first cycle was well-tolerated in both treatment groups. Although the incidence of grade 3/4 neutropenia was lower than previously reported for this regimen, DSN appeared to be similar for patients in the same-day and next-day groups. Additionally, few patients experienced reductions or delays in CT delivery.

[Table: see text]

[Table: see text]

Randomized, double-blind, phase 2, study evaluating same-day vs next-day administration of pegfilgrastim with R-CHOP in non-Hodgkin’s lymphoma patients

7570

Background: R-CHOP is associated with a high risk of febrile neutropenia (FN). Pegfilgrastim is indicated to lower infection incidence, manifested by FN, when administered once-per-cycle 24 hrs after chemotherapy (CT). However, eliminating an office visit the day after CT is desirable. Methods: Pts ≥ 18 years with previously untreated non-Hodgkin’s lymphoma (NHL) who received R-CHOP (rituximab 375 mg/m2, C 750 mg/m2, H 50 mg/m2, O 1.4 mg/m2, prednisone 100 mg; for 6 cycles Q21D) were randomized 1:1 to pegfilgrastim 6mg within 4 hours or ∼24hrs after CT. The primary endpoint was the duration of severe (grade 4) neutropenia (DSN) in cycle 1. Same-day administration was considered noninferior to next-day if the upper limit of the 2-sided 95% CI for the difference in mean cycle 1 DSN (same day - next day) was <2 days. Results: 77 pts (8 mantle-cell, 69 diffuse large B-cell) were enrolled of 90 planned (due to slow accrual). 75 pts (36 same-day, 39 next-day) received CT and pegfilgrastim. Most pts had stage 3/4 disease (69% same-day, 74% next-day), no bone marrow involvement (75% same-day, 69% next-day) and ECOG status 0 or 1 (94% same-day, 97% next-day). Difference in mean cycle 1 DSN was 0.9 days (95% CI: 0.3–1.4) longer in the same-day than the next-day group (mean [SD]: 2.1 [1.22] vs 1.2 [1.20] days; grade 4 neutropenia incidence: 86% vs 64%). In cycle 1, more pts had a DSN ≥ 3 days in the same-day (36%) than the next-day group (15%). In cycle 4, mean DSN was longer in the same-day than the next-day group (mean [SD] 1.4 [1.40] vs 0.7 [0.94] days; grade 4 neutropenia incidence: 57% vs 42%). Pts in the 2 groups had similar occurrence of FN (17% vs 15%) and serious adverse events (33% vs 36%) across the study. Full dose on schedule, and the incidence of IV anti-infective use or hospitalization due to FN were also similar between groups. Conclusions: In cycles 1 and 4, the mean DSN was nearly 1 day longer for pts in the same-day group compared with the next-day group. Although the protocol-specified 2-day non-inferiority margin for DSN was met, for pts with NHL receiving R-CHOP, we recommend administering pegfilgrastim 24 hours after CT per labeling guidelines.

[Table: see text]

Mitochondrial and nuclear DNA damage induced by sulphur mustard in keratinocytes

The extent and role of mitochondrial DNA damage in the mechanism of action of sulphur mustard (SM) is poorly understood. In this study, a combination of quantitative polymerase chain reaction and Southern hybridization was used to determine the levels of both total DNA adducts and DNA interstrand crosslinks in genomic and mitochondrial DNA isolated from normal human epidermal keratinocytes exposed to SM. The formation of both types of lesions occurred simultaneously in nuclear and mitochondrial DNA, however, SM produced significantly higher levels of both total adducts and crosslinks in genomic DNA than mitochondrial DNA. The total lesion frequency was 0.45 lesions/kb per 100 microM SM in the DHFR gene and 0.12 lesions/kb per 100 microM SM in the mitochondrial segment. Interstrand crosslinks occurred at a frequency of 0.28 crosslinks/10 kb per 100 microM SM in the DHFR gene and 0.05 crosslinks/10 kb per 100 microM SM in the mitochondrial segment. DNA interstrand crosslinks are thought to be the critical lesion produced by similar bi-functional alkylating agents. However, the levels of DNA cross-linking revealed in this study show that even at vesicating doses of SM mitochondrial DNA is still largely free of cross-links and the predominant form of DNA damage contributing to cell death occurs in the nucleus.

SC1, a SPARC-related glycoprotein, exhibits features of an ECM component in the developing and adult brain

Although extracellular matrix (ECM) components have been shown to play important roles in the development of the CNS, expression generally decreases in the adult brain. This study examines the expression of the SPARC-related glycoprotein SC1 in the rat brain during postnatal development and in the adult. In situ hybridization analysis indicates that expression of SC1 mRNA increases in a caudal to rostral manner as postnatal neural development proceeds and is found at near maximal levels in the adult brain. SC1 mRNA is expressed in glial-enriched areas of the brain at postnatal day 1 (P1) and P5. Between P10 and P20, SC1 mRNA increases in neuron-enriched regions of the hippocampus, dentate gyrus, and cerebral cortex. Immunohistochemistry in the adult shows that SC1 protein is localized to neurons in these regions and to scattered glial cells. Subcellular fractionation demonstrates that the SC1 116/120 kDa doublet is associated with synaptosomes. SC1 is present in the aqueous phase following extraction of membranes with TX-114, suggesting that it is not a transmembrane protein, a property consistent with other adult brain ECM components. Furthermore in cerebellar granule cells grown in culture, high levels of the 120 kDa component are secreted into the media. These results are consistent with the hypothesis that SC1 is an ECM glycoprotein expressed in both the developing and adult brain.

Paf antagonists block induction of nitric oxide synthase in cultured macrophages and vascular smooth muscle cells

1. Nitric oxide (NO) synthase inhibitors and Paf antagonists abrogate hypotension in septic shock. The latter may act by blocking intracellular transduction mechanisms in vascular smooth muscle cells and inflammatory cells. We examined the effect of Paf antagonists on expression of inducible NO synthase. 2. A murine macrophage cell line (J774.2) and rat vascular smooth muscle cells (VSMC) were stimulated with lipopolysaccharide (LPS), either alone or in combination with Paf or Paf antagonists, BN 50739 or E-6123. 3. NO synthase activity in J774.2 was measured by the conversion of [3H]L-arginine to [3H]L-citrulline. Nitrite accumulation was measured in the culture medium of J774.2 and VSM. 4. BN 50739 (10 mumol/L and E-6123 (1 mumol#L) both reduced the expression of calcium-independent NO synthase activity and nitrite accumulation, while Paf alone had no effect. 5. Inhibition of NO synthase induction by Paf antagonists might afford therapeutic benefits in the management of septic shock and possibly other cardiovascular disorders.

Developmental expression in the rat cerebellum of SC1, a putative brain extracellular matrix glycoprotein related to SPARC

In the nervous system, extracellular matrix (ECM) molecules have been shown to have effects on cell migration, process outgrowth and the survival of neurons. Recently we have described the molecular cloning of SC1, a putative brain extracellular matrix glycoprotein, showing partial similarity to the ECM glycoprotein SPARC/osteonectin. We have now examined the expression of SC1 during the development of the rat cerebellum at both the protein and mRNA levels. Our results indicate that SC1 is both temporally and spatially regulated during this process. Bergmann glial cells express SC1 mRNA and the resultant protein is deposited along the length of their radial fibres during the process of granule cell migration in the developing cerebellum. SC1 mRNA and protein is also found in the adult cerebellum, concentrated in the Bergmann glial cells and their radial processes, indicating that this putative ECM molecule continues to play roles in the central nervous system after migration and proliferative events have ceased.

Clinicopathologic features of hypertrophic cardiomyopathy managed by cardiac transplantation

Clinical records, electrocardiographic, echocardiographic, hemodynamic and radionuclide data, and the operatively excised hearts were reviewed in 10 patients (aged 19 to 46 years, mean 35) who had cardiac transplantation for hypertrophic cardiomyopathy. Severe congestive heart failure unassociated with outflow obstruction was the indication for transplantation in 9 patients. During a pretransplantation period ranging from 45 to 312 months (mean 137) in these 9 patients, pulmonary artery wedge pressure increased from 19 +/- 9 to 27 +/- 7 mm Hg, left ventricular ejection fraction decreased from 51 +/- 11% to 41 +/- 1%, left ventricular end-diastolic dimension increased from 42 +/- 6 to 48 +/- 4 mm, and total 12-lead QRS voltage decreased from 209 +/- 50 to 156 +/- 41 mm. In these 9 patients, the explanted hearts had dilated left ventricular cavities, and 8 had left ventricular scars without significant narrowing of the epicardial coronary arteries. The tenth patient had a nondilated left ventricular cavity and had transplantation because of recurrent, refractory syncope. Of the 10 patients, 3 died within the first month, and another died 8 months after transplantation. The remaining 6 patients have survived 20 to 54 months (mean 39) after transplantation and are in functional class I or II.

Distribution of the slow/cardiac isoform of skeletal muscle Ca(2+)-ATPase in developing and mature tissues of chickens determined using a monoclonal antibody

We have established that the monoclonal antibody (MAb) AA21, raised against a crude sarcolemmal fraction prepared from adult chicken anterior latissimus dorsi muscle, recognizes the slow twitch/cardiac isoform of calcium ATPase. This was done using a combination of immunohistochemistry at the light and electron microscopic level, the change in the cell distribution in skeletal muscle during development, the molecular weight of the principal protein recognized in Western transfers, and direct comparison with another MAb of known specificity. The antigen is initially expressed by all myotubes at E10 and with development is gradually lost from all presumptive fast fibers. In addition to its immunoreaction and slow extrafusal skeletal muscle fibers, AA21 displays a highly selective immunoreactivity with a number of other cell types in different tissues. The antibody stains a subset of intrafusal muscle fibers and intestinal and arterial smooth muscle, but not venous smooth muscle. In the nervous system, a subpopulation of neurons is intensely stained, most neurons are faintly stained, and glia are not stained at all.

Thy-1-like immunoreactivity in developing chicken skeletal muscle: identification of a cross-reactive slow-fiber specific molecule that is not Thy-1

We investigated the Thy-1-like immunoreactivity during the development of chicken skeletal muscle using a group of monoclonal antibodies raised and characterised against purified chicken brain Thy-1. The immunoreactivity attributable to bona fide Thy-1 in muscle was present in nerves, connective tissue associated with the intrafusal capsule and blood vessels, and the extracellular matrix of the muscle fibres. During development there was no change in the staining of nerves, blood vessels or intrafusal capsules. However, the extracellular staining of muscle first appeared around hatching and gradually increased in intensity reaching maximal levels in the adult. The intensity of staining varied within and between the muscles examined. One of the antibodies (SB1 20.11) recognised an additional molecule that is not Thy-1 and that was localised in the cytoplasm of slow muscle fibres. This immunoreactivity was first detectable at E10 in all myotubes that contained both alkali and acid stable myosin ATPase activity (presumptive slow), but not in those myotubes with only alkali-stable myosin ATPase activity (presumptive fast). Thereafter, the staining increased to a maximum in the newly hatched animal and then decreased until reactivity was undetectable in the adult (greater than 25 weeks). All positive fibres initially stained with a uniform intensity but the time of commencement and the rate of loss of staining was variable. Those fibres that contained both acid stable and acid labile myosin ATPase activity lost the antigen much faster than the fibres containing only acid-stable myosin ATPase activity, which also tended to increase in intensity for a longer period. These may represent, respectively, the slow tonic type III fibres and the slow twitch type I fibres classified by Barnard et al. (1982).

A monoclonal antibody against the slow isoform of skeletal muscle Ca2+-ATPase selectively stains a subpopulation of neurons in the central nervous system

A monoclonal antibody against the slow isoform of chicken skeletal muscle Ca2+-ATPase recognises, in nervous tissue, analogous membrane proteins which are most concentrated in the microsomal fraction. Histochemically, the immunoreactivity of the antibody is restricted to neurones where the staining is most intense in cell bodies and dendrites, weak in axons and absent from cell nuclei. The expression of the antigen varies greatly between different neuronal populations and is developmentally regulated. The antigen is also axonally transported.

Incidence of sporadic infections due to enterotoxigenic Escherichia coli (ETEC) in the population of Hamburg, north Germany

In two studies (1982 and 1985/86), the presence of enterotoxigenic E. coli (ETEC) and other enteropathogenic bacteria was investigated in 779 stool specimens from children and adults with and without diarrhoeal disease. ETEC was isolated from 2% of diseased children and 1.6% of adult patients, but also from 0.5% of asymptomatic persons. Mixed infections with two different ETEC strains or with other enteropathogenic bacteria were identified in 4 of 9 infected persons. The ETEC strains belonged to 10 different serovars, eight of which produced only heat-stable enterotoxin. One infection had been contracted in a tropical country. After Salmonella and Campylobacter, ETEC was more frequently isolated than Yersinia and Shigella; the difference of ETEC infections in diseased and asymptomatic persons was, however, not statistically significant (p greater than 0.05). Analysis of the isolated serovars suggests that most ETEC strains implicated in sporadic cases of diarrhoea in Hamburg are unrelated to those which are widely spread in the developing world.

Transurethral treatment of bladder diverticula. Alternative to open diverticulectomy

Since October, 1980, we have used transurethral fulguration of the diverticular mucosa and incision of the diverticular neck in combination with electrohydraulic lithotripsy of bladder stones and transurethral prostatic resection to treat all aspects of diverticula in 11 patients. In comparing the results with those of open diverticulectomy, we found the transurethral procedure to be equally effective while being safer, faster, and less expensive.

Pre treatment by the crude and the n-hexane extract of <i>Nigella sativa</i> Linn. (Kalajira) alleviates diabetes mellitus

Methodology: Effect of pretreatment by crude and n-Hexane extract of Nigella (10mg/kg body wt./day for 21 days) on streptozotocin (STZ, 50 mg/kg body wt. single dose i.p.) administered rats were observed in the present study. Biochemical parameters (Serum glucose, serum TG, serum cholesterol, pancreatic GSH) were compiled together with pancreatic histology. Results: Both the crude and the n-Hexane extract of Nigella pre-treated diabetic rats had demonstrated significant (P<0.001) alleviation from the elevated serum glucose, lowered pancreatic reduced glutathione (P<0.01) and elevated serum TG concentrations (P<0.01). 72% β cells appeared to be damaged by STZ administration, while in the crude and the n-Hexane extract of Nigella pretreated diabetic groups this damage was 31% and 46% respectively, the crude Nigella pretreated group thus appeared to have better amelioration. Conclusions: Further studies are suggested to obtain the protective ingredient from the crude Nigella and to observe its effect upon the above mentioned parameters of diabetic rats in higher doses for prolonged periods. Keywords: Diabetes, Nigella sativa Linn., Streptozotocin. doi: 10.3329/bjms.v8i1.3182 Bangladesh Journal of Medical Science Vol.8 No. 1-2; 2009 5-9

Evaluation of the antibody response against Hepatitis B Virus infection in patients on maintenance hemodialysis: A Pilot Study

Objective: This study was undertaken to evaluate the antibody response of hepatitis B virus infection in patients on maintenance hemodialysis (MHD) by detecting different viral markers. Method: Study subjects comprised a total of 88 chronic kidney disease (CKD) patients from Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) and Bangabandhu Sheikh Mujib Medical University (BSMMU). Of them 63 patients on MHD and 25 predialysis patients served as cases and controls respectively. Clinical history was taken and serological markers for HBV (HBsAg, Anti-HBs, and Anti-HBc) were determined by using ELISA. Results: Hepatitis B virus was positive in 1.6% of maintenance hemodialysis (MHD) patients and in 16% of controls (p<0.02). Anti-HBc antibody was positive in 62% of dialysis patients and 72% of controls (p=NS) and the positivity was significantly associated in dialysis subjects with longer duration of dialysis (18 ± 22 vs. 10 ± 7, months, p<0.04), multiple units of blood transfusions (22 ± 29 vs. 10 ± 12, units, p<0.04) and more reuse of dialyzer (3 ± 1 vs. 2 ± 1, times, p<0.03) than the negative ones. Among MHD patients 84% were vaccinated against HBV with a schedule of 3 (79%) and 4 (21%) doses and protective antibody titer (>10 IU/L) was found in 57%. None of the controls were vaccinated but 66% had protective titer indicating post exposure natural immunity. Conclusions: Hepatitis B virus positivity was significantly higher among the predialysis subjects compared to dialysis group. Key words: Hepatitis B virus, Antibody response, Hemodialysis doi: 10.3329/bjms.v8i1.3185 Bangladesh Journal of Medical Science Vol.8 No. 1-2; 2009 15-21