Antineoplastics
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Reactions 1490, p8 - 1 Mar 2014 S Antineoplastics Hepatitis B reactivation: case report A 43-year-old man experienced hepatitis B reactivation after receiving antineoplastics for non-Hodgkin’s lymphoma. The man, who had a history of a resolved hepatitis B (HBV) infection, received six cycles of R-CHOP chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone [dosages and routes not stated] within 4 months of his lymphoma diagnosis in 2005. He achieved complete remission after radiotherapy; however, 1 year later, a relapse occurred. He then received three cycles of R-DHAP chemotherapy over 2 months, consisting of rituximab, dexamethasone, cisplatin and cytarabine [dosages and routes not stated]. In each of the next two months, he received one cycle of high-dose CMV therapy (cyclophosphamide, etoposide, melphalan and dexamethasone) with gemcitabine 1500mg [routes not stated; dosage information incomplete]. He also received two cycles of stem cell therapy. Four months after CMV therapy, tests were strongly positive for HBV surface antigen (HBsAg), while HBs antibodies had disappeared. His HBV viral load was greater than 1.8 × 10 7 copies/mL. The man received lamivudine, and his viral load subsequently decreased to undetectable levels. He remained alive with his lymphoma in stable disease status at last follow- up. Sequencing analysis of the small HbsAg protein revealed HBV genotype D with five mutations, including two known escape mutations. Author comment: "We report a case of HBV reactivation in an anti-HBs positive, anti-HBc positive non-Hodgkin’s lymphoma patient. Hepatitis B virus (HBV) reactivation is a well-recognized complication of patients undergoing chemotherapy or immunosuppressive therapy for lymphomas." Wu C, et al. A case of hepatitis B reactivation in an anti-HBs positive, anti-HBc positive non-Hodgkin’s lymphoma patient. Virologica Sinica 28: 49-52, No. 1, Feb 2013. Available from: URL: http://doi.org/10.1007/s12250-013-3285-x - China 803099964 1 Reactions 1 Mar 2014 No. 1490 0114-9954/14/1490-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1490, p8 - 1 Mar 2014
SAntineoplastics
Hepatitis B reactivation: case reportA 43-year-old man experienced hepatitis B reactivation after
receiving antineoplastics for non-Hodgkin’s lymphoma.The man, who had a history of a resolved hepatitis B (HBV)
infection, received six cycles of R-CHOP chemotherapy withrituximab, cyclophosphamide, doxorubicin, vincristine andprednisone [dosages and routes not stated] within 4 months ofhis lymphoma diagnosis in 2005. He achieved completeremission after radiotherapy; however, 1 year later, a relapseoccurred. He then received three cycles of R-DHAPchemotherapy over 2 months, consisting of rituximab,dexamethasone, cisplatin and cytarabine [dosages and routesnot stated]. In each of the next two months, he received onecycle of high-dose CMV therapy (cyclophosphamide,etoposide, melphalan and dexamethasone) with gemcitabine1500mg [routes not stated; dosage information incomplete].He also received two cycles of stem cell therapy. Four monthsafter CMV therapy, tests were strongly positive for HBVsurface antigen (HBsAg), while HBs antibodies haddisappeared. His HBV viral load was greater than1.8 × 107 copies/mL.
The man received lamivudine, and his viral loadsubsequently decreased to undetectable levels. He remainedalive with his lymphoma in stable disease status at last follow-up. Sequencing analysis of the small HbsAg protein revealedHBV genotype D with five mutations, including two knownescape mutations.
Author comment: "We report a case of HBV reactivationin an anti-HBs positive, anti-HBc positive non-Hodgkin’slymphoma patient. Hepatitis B virus (HBV) reactivation is awell-recognized complication of patients undergoingchemotherapy or immunosuppressive therapy forlymphomas."Wu C, et al. A case of hepatitis B reactivation in an anti-HBs positive, anti-HBcpositive non-Hodgkin’s lymphoma patient. Virologica Sinica 28: 49-52, No. 1, Feb2013. Available from: URL: http://doi.org/10.1007/s12250-013-3285-x -China 803099964
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Reactions 1 Mar 2014 No. 14900114-9954/14/1490-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
