Antineoplastics
1
Reactions 1333 - 8 Jan 2011 S Antineoplastics Hepatitis B reactivation: 4 case reports Three women and one man received chemotherapy [routes and dosages not stated] and developed hepatitis B virus (HBV) reactivations. A 38-year-old woman with breast cancer and known HBV infection received neoadjuvant chemotherapy with doxorubicin and cyclophosphamide. After 4 cycles, she developed persistent nausea and vomiting, with elevated AST, ALT and total bilirubin. Hepatitis serologies revealed HBV reactivation. She received entecavir but developed severe coagulopathy and hepatic encephalopathy. She underwent liver transplantation and left mastectomy, and at 2-year follow-up she is continuing to receive antivirals and immunoprophylaxis, with no recurrence of her breast cancer. A 71-year-old woman received paclitaxel and carboplatin for endometrial cancer. After 3 cycles, AST and ALT elevations were detected. Investigations revealed HBV reactivation. Chemotherapy was discontinued and she began receiving entecavir. She was then able to complete her chemotherapy course. At last follow-up, her aminotransferase levels were normal and she had undetectable HBV DNA. A 51-year-old man with diffuse large B-cell lymphoma completed 8 cycles of chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone. About 1 month after his last cycle, he developed jaundice, dark urine and pale, loose stools. AST, ALT and total bilirubin were elevated and hepatitis serologies led to a diagnosis of HBV reactivation secondary to chemotherapy. He received entecavir and at last follow- up his aminotransferases and bilirubin had normalised, and his HBV DNA was undetectable. A 78-year-old woman with diffuse large B-cell lymphoma completed 6 cycles of chemotherapy with rituximab, etoposide, vincristine, doxorubicin, cyclophosphamide, and prednisone. One month after completion, elevated AST and ALT were detected. Investigations revealed HBV reactivation. She received entecavir and her aminotransferase levels returned to within normal limits. Author comment: "Immunosuppressive therapy enhances viral replication. . . Risk factors for HBV reactivation include chemotherapy regimens containing glucocorticoids and anthracyclines." King LY, et al. When treating cancer, please don’t forget hepatitis B. Oncologist 15: 826-829, No. 8, Aug 2010. Available from: URL: http://dx.doi.org/10.1634/ theoncologist.2009-0282 - USA 803046688 1 Reactions 8 Jan 2011 No. 1333 0114-9954/10/1333-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
-
Upload
phamkhuong -
Category
Documents
-
view
212 -
download
0
Transcript of Antineoplastics
Reactions 1333 - 8 Jan 2011
SAntineoplastics
Hepatitis B reactivation: 4 case reportsThree women and one man received chemotherapy
[routes and dosages not stated] and developed hepatitis Bvirus (HBV) reactivations.
A 38-year-old woman with breast cancer and knownHBV infection received neoadjuvant chemotherapy withdoxorubicin and cyclophosphamide. After 4 cycles, shedeveloped persistent nausea and vomiting, with elevatedAST, ALT and total bilirubin. Hepatitis serologies revealedHBV reactivation. She received entecavir but developedsevere coagulopathy and hepatic encephalopathy. Sheunderwent liver transplantation and left mastectomy, andat 2-year follow-up she is continuing to receive antiviralsand immunoprophylaxis, with no recurrence of her breastcancer.
A 71-year-old woman received paclitaxel and carboplatinfor endometrial cancer. After 3 cycles, AST and ALTelevations were detected. Investigations revealed HBVreactivation. Chemotherapy was discontinued and shebegan receiving entecavir. She was then able to completeher chemotherapy course. At last follow-up, heraminotransferase levels were normal and she hadundetectable HBV DNA.
A 51-year-old man with diffuse large B-cell lymphomacompleted 8 cycles of chemotherapy with rituximab,cyclophosphamide, doxorubicin, vincristine andprednisone. About 1 month after his last cycle, hedeveloped jaundice, dark urine and pale, loose stools. AST,ALT and total bilirubin were elevated and hepatitisserologies led to a diagnosis of HBV reactivation secondaryto chemotherapy. He received entecavir and at last follow-up his aminotransferases and bilirubin had normalised, andhis HBV DNA was undetectable.
A 78-year-old woman with diffuse large B-cell lymphomacompleted 6 cycles of chemotherapy with rituximab,etoposide, vincristine, doxorubicin, cyclophosphamide,and prednisone. One month after completion, elevated ASTand ALT were detected. Investigations revealed HBVreactivation. She received entecavir and heraminotransferase levels returned to within normal limits.
Author comment: "Immunosuppressive therapy enhancesviral replication. . . Risk factors for HBV reactivation includechemotherapy regimens containing glucocorticoids andanthracyclines."King LY, et al. When treating cancer, please don’t forget hepatitis B. Oncologist15: 826-829, No. 8, Aug 2010. Available from: URL: http://dx.doi.org/10.1634/theoncologist.2009-0282 - USA 803046688
1
Reactions 8 Jan 2011 No. 13330114-9954/10/1333-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
