Precore mutant hepatitis B reactivation after treatment with CHOP-rituximab.
A patient with stage IV non-Hodgkin's lymphoma and chronic hepatitis who was treated with chemotherapy and rituximab developed fatal reactivation of hepatitis B. High viral load titers of hepatitis B DNA were demonstrated. DNA sequencing analysis revealed the presence of the precore mutant strain. Hepatitis B reactivation in patients receiving rituxmab-based chemotherapy is reviewed and the role of precore mutant virus strains resulting in fatal complications is discussed.
Zell
Jason A
JA
Division of Hematology/Oncology, Department of Medicine, College of Medicine, University of California Irvine, Irvine, CA, USA. jzell@uci.edu
Yoon
Eugene J
EJ
Ignatius Ou
S-H
SH
Hoefs
John C
JC
Chang
Jae C
JC
D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D017809:Fatal Outcome; D006509:Hepatitis B / Q000139:chemically induced* / Q000821:virology; D006515:Hepatitis B virus / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D009367:Neoplasm Staging; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D012008:Recurrence; D000069283:Rituximab; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects; D014775:Virus Activation / Q000187:drug effects*
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone