Fatal hepatitis B virus reactivation in a chronic myeloid leukemia patient during imatinib mesylate treatment.
Reactivation of chronic hepatitis B virus (HBV) infection in patients undergoing chemotherapy is well-documented, but reactivation during imatinib mesylate treatment has not been reported. This study reports a 54-year-old man, without prior liver dysfunction but with chronic HBV infection, in whom fatal HBV reactivation occurred during treatment of chronic myeloid leukemia (CML) with imatinib mesylate. He developed fulminant hepatitis followed by marked elevation of HBV DNA polymerase, probably from the lymphocytopenic and immunosuppressive status induced by imatinib mesylate. Imatinib mesylate is widely used to treat CML patients. Although therapy with imatinib mesylate is generally well tolerated, the case presented here suggests that viral reactivation should be considered, even when using imatinib mesylate to treat CML.
Ikeda
K
K
First Department of Internal Medicine, Fukushima Medical University, Fukushima, Japan.
Shiga
Y
Y
Takahashi
A
A
Kai
T
T
Kimura
H
H
Takeyama
K
K
Noji
H
H
Ogawa
K
K
Nakamura
A
A
Ohira
H
H
Sato
Y
Y
Maruyama
Y
Y
D000970:Antineoplastic Agents / Q000009:adverse effects*; D001549:Benzamides; D017809:Fatal Outcome; D006515:Hepatitis B virus / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000009:adverse effects*; D011743:Pyrimidines / Q000009:adverse effects*; D013997:Time Factors; D014775:Virus Activation / Q000187:drug effects
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate