Late lethal hepatitis B virus reactivation after rituximab treatment of low-grade cutaneous B-cell lymphoma.
The chimeric anti-CD20 monoclonal antibody, rituximab, is a promising treatment for cutaneous B-cell lymphomas. Classically used in combination with a multiagent-chemotherapy regimen, it can sometimes give excellent results alone. Because of its selective action on B lymphocytes, it is considered a moderate immunosuppressant in terms of infection. We describe a woman with relapsed cutaneous follicular centre B-cell lymphoma and secondary lymph-node involvement treated with rituximab alone, which induced a complete remission. One year later, she experienced a fatal hepatitis B virus (HBV) reactivation. Several such HBV reactivations were reported after combined rituximab and multiagent chemotherapy for B-cell lymphomas. This is the first case of HBV reactivation occurring during the year following rituximab monotherapy in the absence of any other immunosuppressive factor.
Perceau
G
G
CHU de Reims, Hôpital Robert-Debré, Service de Dermatologie et Service de Gastroentérologie, avenue du Général Koenig, 51092 Reims Cedex, France.
Diris
N
N
Estines
O
O
Derancourt
C
C
Lévy
S
S
Bernard
P
P
D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006509:Hepatitis B / Q000139:chemically induced; D006515:Hepatitis B virus / Q000502:physiology*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000473:pathology; D008224:Lymphoma, Follicular / Q000188:drug therapy / Q000473:pathology; D000069283:Rituximab; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology; D014775:Virus Activation / Q000187:drug effects*
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab