الفهرس 
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Abstract
It Was Previously Reported That Liver Disease Is A Major Cause Of Mortality In Bone Marrow Transplant (BMT) Recipients. Pretransplant Viral Hepatitis Was Associated With An Increased Risk For Liver Morbidities And Mortalities, As Liver Graft Versus Host Disease (GVHD) And Veno-Occlusive Disease (VOD). The Current Study Aimed To Evaluate The Impact Of Preemptive Antiviral Therapy For HBV Or HCV On BMT Related Liver Morbidities And Survival. Methods: The Total Studied group Were 61 (M:F 41:20) Patients. With The Intention To Treat, 31/61 In The Prospective group Received Preemptive Antiviral Therapy For Control Of HCV/HBV Load Prior And Through The Stem Cell Transplantation, With Treatment Starting One Month Prior To Scheduled BMT In The HCV group (24/31, 77.4%), And Two Weeks For The HBV group (7/31, 22.6%). They Were Compared Against 30 Retrospective Control group Of Parallel Age (Mean Age At Transplant 11.7 Yrs Vs. 11.6 Yrs In The Treatment group (SD 6yrs)), Pretransplant Diagnosis, BMT Conditioning And Ratio Of Prevalence Of HBV Vs. HCV Infection. Patients’ Data Were Collected Through Institutional Records, With HCV Representing 21/30 (70%) And HBV 9/30 (30%). Variables Were Analyzed Using 2-Tailed T-Test, With 95% Confidence Interval, And Chi -Square Fisher’s Exact Test For Categorical Variables In Both Groups. The Survival Was Analyzed Using The Kaplan-Meier Survival Curves. Results: In The Preemptive Treated Study group 3/31(9.7%) Versus 10/30(33.3%) Of The Control group Showed Development Of Liver GVHD (P=0.03). There Was Also Significantly Reduced Overall Incidence Of GVHD In The Preemptive Treated group (9/22, 29%) Versus The Control group (18/30, 60%) (P=0.01). These Results Are Reflected On The Reduction Of GVHD As Cause Of Mortality (P=0.023), Reaching Near Significant Results In Improving The Overall Survival. Alkaline Phosphatase, A Predictor Of Liver GVHD, Was Significantly Lower In The Treated group Who Did Not Develop Liver GVHD In Comparison To The Comparative Controls For The Whole Year (P<0.01). In Conclusion The Preemptive Therapy Showed To Be Protective Against The Development Of Liver GVHD, With The Influence Of Reducing The chronic GVHD As Cause Of Mortality Post BMT. This Is Most Possibly Secondary To The Control Of Hepatitis Viral Activation. Key Words : Bone Marrow Transplantation – Children - Graft Versus Host Disease – HSCT- HBV- HCV- Lamivudin.