Fulminant hepatic failure in non-Hodgkin lymphoma patients treated with chemotherapy.
Chemotherapy is the mainstay of therapy for patients with non-Hodgkin lymphoma. Among side-effects associated with the use of chemotherapy, immunosuppression is one which can be potentially fatal. In hepatitis B carriers, immunosuppression permits widespread infection of the hepatocytes and its subsequent withdrawal causes an "immunological rebound" leading to massive necrosis of hepatocytes. 4 patients who died of fulminant hepatitis following chemotherapy are reported. These were patients with positive hepatitis B serology. Caution is advised when treating non-Hodgkin lymphoma in patients from hepatitis B endemic regions.
Soh
L T
LT
Department of Medical Oncology, Singapore General Hospital.
Ang
P T
PT
Sng
I
I
Chua
E J
EJ
Ong
Y W
YW
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001761:Bleomycin / Q000009:adverse effects; D056486:Chemical and Drug Induced Liver Injury; D003520:Cyclophosphamide / Q000009:adverse effects; D004317:Doxorubicin / Q000009:adverse effects; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D016867:Immunocompromised Host; D008107:Liver Diseases / Q000401:mortality; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008727:Methotrexate / Q000009:adverse effects; D008875:Middle Aged; D011239:Prednisolone / Q000009:adverse effects; D011241:Prednisone / Q000009:adverse effects; D014750:Vincristine / Q000009:adverse effects
D001761:Bleomycin; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone; D011241:Prednisone; D008727:Methotrexate