title: Hepatitis B virus reactivation in a patient undergoing steroid-free chemotherapy.
abstract: A 62-year-old Japanese man who was positive for hepatitis B surface antigen (HBsAg) and anti-HBe antibody, underwent chemotherapy for non-Hodgkin's lymphoma (NHL). Mutations were detected in the precore region (nt1896) of HBV. Because steroid-containing regimen may cause reactivation of hepatitis B virus (HBV) and hepatitis may progress to be fulminant after its withdrawal, we administered CHO (CPA, DOX and VCR) therapy and the patient obtained complete response. However, he developed acute exacerbation of hepatitis due to HBV reactivation. Recovery was achieved with lamivudine (100 mg/d) and plasma exchange. The present case suggests that acute exacerbation of hepatitis can occur with steroid-free regimen. Because the efficacy of the prophylactic use of lamivudine has been reported and the steroid enhances curability of malignant lymphoma, the steroid containing regimen with prophylaxis of lamivudine should be evaluated further.
authors.affiliation: Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto 602-0841, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Shimizu
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nomura
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Kyoji
authors.initials: K
authors.lastname: Ueda
authors.forename: Kanji
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Masahito
authors.initials: M
authors.lastname: Minami
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Itoh
authors.forename: Shigeo
authors.initials: S
authors.lastname: Horiike
authors.forename: Masuji
authors.initials: M
authors.lastname: Morita
authors.forename: Masafumi
authors.initials: M
authors.lastname: Taniwaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okanoue
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000009:adverse effects* / Q000627:therapeutic use; D004317:Doxorubicin / Q000009:adverse effects* / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000187:drug effects*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D014750:Vincristine / Q000009:adverse effects* / Q000627:therapeutic use; D014775:Virus Activation
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide