Successful antiviral treatment for fulminant reactivated hepatitis B after autologous stem cell transplantation and prophylaxis during subsequent allogeneic stem cell transplantation.
The risk of severe hepatic damage due to reactivation of hepatitis B virus (HBV) infection after intensive myelosuppressive chemotherapy is well known. Two of the most evolved nucleotide analogues showing good activity against the hepatitis B virus are lamivudine and famciclovir. We report the successful therapeutic use of lamivudine and famciclovir for fulminant reactivated hepatitis B after autologous peripheral blood stem cell transplantation (PBSCT) and the subsequent prophylactic use of lamivudine during allogeneic blood stem cell transplantation (alloSCT) for chronic lymphocytic leukemia (CLL) in a 40-year-old patient. Antiviral therapy was well tolerated and no hematotoxicity occurred. Our observation warrants further investigation of antiviral therapy with famciclovir and lamivudine in HBV carriers receiving intensive myelosuppressive chemotherapy.
Henkes
M
M
Department of Internal Medicine II, Robert-Bosch-Hospital, Auerbachstrasse 110, 70376 Stuttgart, Germany.
Martin
S
S
Einsele
H
H
Aulitzky
W E
WE
D015075:2-Aminopurine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D000077595:Famciclovir; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006509:Hepatitis B / Q000188:drug therapy* / Q000517:prevention & control*; D006515:Hepatitis B virus / Q000254:growth & development*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014775:Virus Activation
D000998:Antiviral Agents; D019259:Lamivudine; D015075:2-Aminopurine; D000077595:Famciclovir