Symbole graficzne aparatów, maszyn i urządzeń przemysłu chemicznego
Antineoplastics
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Reactions 1193 - 15 Mar 2008 S Antineoplastics Hepatitis B virus reactivation leading to fatal fulminant hepatitis B in an elderly patient: case report A 77-year-old woman developed fulminant hepatitis B due to hepatitis B virus reactivation after completing treatment with cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab [dosages and treatment durations not stated] for non-Hodgkin’s lymphoma; she subsequently died. The woman had been diagnosed with marginal-zone non- Hodgkin’s lymphoma transformed to large-cell B lymphoma in December 2004; at this time, serology test results were positive for anti-HBc antibody, but negative for other HBV markers. She received six cycles of CHOP, comprising cyclophosphamide, doxorubicin, vincristine and prednisone, followed by two cycles of rituximab [MabThera]; the last cycle was administered on 8 June 2005. During treatment, she also received valaciclovir and cotrimoxazole [trimethoprim/ sulfamethoxazole]. In June 2005, 2 weeks after chemotherapy completion, her AST and ALT levels were found to be elevated at twice and four times the upper limit of normal, respectively, and she developed jaundice; she was hospitalised 1 week later, on 7 July 2005. Laboratory findings were consistent with HBV reactivation. Lamivudine was started and, after 4 days’ treatment with no improvement, adefovir was added. However, the woman’s hepatocellular insufficiency deteriorated with progression to hepatic encephalopathy. She was transferred to an ICU and underwent treatment by molecular adsorbent recirculating system, but did not improve and, 11 days after admission, she died. Author comment: The patient received the CHOP regimen, combined with rituximab and corticosteroids. Therefore it is difficult to draw a conclusion regarding which of the agents is implicated in the hepatitis B virus reactivation. Thirot-Bidault A, et al. Fatal liver failure after hepatitis B reactivation following chemotherapy for lymphoma in a patient with only anti-HBc antibody and review of the literature. Gastroenterologie Clinique et Biologique 31: 1028-1031, No. 11, Nov 2007 [French; summarised from a translation] - France 801101000 1 Reactions 15 Mar 2008 No. 1193 0114-9954/10/1193-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1193 - 15 Mar 2008
SAntineoplastics
Hepatitis B virus reactivation leading to fatalfulminant hepatitis B in an elderly patient: casereport
A 77-year-old woman developed fulminant hepatitis B dueto hepatitis B virus reactivation after completing treatmentwith cyclophosphamide, doxorubicin, vincristine, prednisoneand rituximab [dosages and treatment durations not stated] fornon-Hodgkin’s lymphoma; she subsequently died.
The woman had been diagnosed with marginal-zone non-Hodgkin’s lymphoma transformed to large-cell B lymphoma inDecember 2004; at this time, serology test results werepositive for anti-HBc antibody, but negative for other HBVmarkers. She received six cycles of CHOP, comprisingcyclophosphamide, doxorubicin, vincristine and prednisone,followed by two cycles of rituximab [MabThera]; the last cyclewas administered on 8 June 2005. During treatment, she alsoreceived valaciclovir and cotrimoxazole [trimethoprim/sulfamethoxazole]. In June 2005, 2 weeks after chemotherapycompletion, her AST and ALT levels were found to be elevatedat twice and four times the upper limit of normal, respectively,and she developed jaundice; she was hospitalised 1 weeklater, on 7 July 2005. Laboratory findings were consistent withHBV reactivation.
Lamivudine was started and, after 4 days’ treatment with noimprovement, adefovir was added. However, the woman’shepatocellular insufficiency deteriorated with progression tohepatic encephalopathy. She was transferred to an ICU andunderwent treatment by molecular adsorbent recirculatingsystem, but did not improve and, 11 days after admission, shedied.
Author comment: The patient received the CHOPregimen, combined with rituximab and corticosteroids.Therefore it is difficult to draw a conclusion regarding whichof the agents is implicated in the hepatitis B virus reactivation.Thirot-Bidault A, et al. Fatal liver failure after hepatitis B reactivation followingchemotherapy for lymphoma in a patient with only anti-HBc antibody and reviewof the literature. Gastroenterologie Clinique et Biologique 31: 1028-1031, No. 11,Nov 2007 [French; summarised from a translation] - France 801101000
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Reactions 15 Mar 2008 No. 11930114-9954/10/1193-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
