Antineoplastics
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Reactions 1350 - 7 May 2011 S Antineoplastics Fatal hepatitis B virus reactivation: case report A 50-year-old man experienced a fatal hepatitis B virus (HBV) reactivation during treatment with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone for splenic marginal zone lymphoma. The man was diagnosed with splenic marginal zone lymphoma in November 2005, and started receiving chemotherapy consisting of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone [routes and dosages not stated]. Additionally, he started receiving lamivudine 7 days prior to chemotherapy initiation. In September 2006, he presented with jaundice and abnormal liver enzyme levels. Hepatitis B serology showed HBsAg (+), anti-HBc IgM (+), HBeAg (–), and anti-HBe (+). The man received adefovir. However, his condition deteriorated over the next month with worsening jaundice, elevated liver enzymes, prolongation of prothrombin time and the development of ascites. He had a HBV DNA of 1 × 10 8 copies/mL and genotyping analysis revealed M204V and L180M mutations. He received entecavir, but developed hepatic encepalopathy and died 3 days later due to multiple organ failure. Author comment: "[S]evere HBV reactivation can occur during intensive immunosuppression despite the prophylactic treatment with lamivudine and initial undetectable viral load." Deutsch M, et al. Fatal hepatitis B virus reactivation due to a lamivudine mutant despite undetectable initial viral load. European Journal of Gastroenterology and Hepatology 23: 109, No. 1, Jan 2011 - Greece 803053874 1 Reactions 7 May 2011 No. 1350 0114-9954/10/1350-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Antineoplastics
Reactions 1350 - 7 May 2011
SAntineoplastics
Fatal hepatitis B virus reactivation: case reportA 50-year-old man experienced a fatal hepatitis B virus
(HBV) reactivation during treatment with rituximab,cyclophosphamide, doxorubicin, vincristine, andprednisone for splenic marginal zone lymphoma.
The man was diagnosed with splenic marginal zonelymphoma in November 2005, and started receivingchemotherapy consisting of rituximab, cyclophosphamide,doxorubicin, vincristine, and prednisone [routes anddosages not stated]. Additionally, he started receivinglamivudine 7 days prior to chemotherapy initiation. InSeptember 2006, he presented with jaundice and abnormalliver enzyme levels. Hepatitis B serology showed HBsAg(+), anti-HBc IgM (+), HBeAg (–), and anti-HBe (+).
The man received adefovir. However, his conditiondeteriorated over the next month with worsening jaundice,elevated liver enzymes, prolongation of prothrombin timeand the development of ascites. He had a HBV DNA of1 × 108 copies/mL and genotyping analysis revealed M204Vand L180M mutations. He received entecavir, butdeveloped hepatic encepalopathy and died 3 days later dueto multiple organ failure.
Author comment: "[S]evere HBV reactivation can occurduring intensive immunosuppression despite the prophylactictreatment with lamivudine and initial undetectable viral load."Deutsch M, et al. Fatal hepatitis B virus reactivation due to a lamivudine mutantdespite undetectable initial viral load. European Journal of Gastroenterology andHepatology 23: 109, No. 1, Jan 2011 - Greece 803053874
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Reactions 7 May 2011 No. 13500114-9954/10/1350-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
