title: Hepatitis B viral reactivation secondary to imatinib treatment in a patient with gastrointestinal stromal tumor.
abstract: Hepatitis B virus (HBV) reactivation is a known risk in cancer patients receiving cytotoxic or immunosuppressive therapy; however, the risk associated with newer molecularly-targeted agents has not been well-quantified. Imatinib, a small molecule inhibitor directed against BCR-ABL, CKIT, and other tyrosine kinases, has been associated with HBV reactivation primarily in patients treated for chronic myelogenous leukemia. Herein we present the first reported case of a patient who developed HBV reactivation while receiving imatinib therapy for a gastrointestinal stromal tumor (GIST) in the adjuvant setting. This eventually resulted in fulminant liver failure and was effectively treated with living-related donor liver transplant and anti-viral medication. Currently, no guidelines exist for HBV screening prior to imatinib therapy. This report emphasizes the need for such guidelines and supports the idea that viral reactivation is a risk in all imatinib-treated patients, regardless of the underlying disease.
authors: University of California, San Francisco, School of Medicine. San Francisco, CA, U.S.A.
authors: Evan J
authors: EJ
authors: Walker
authors: Departments of Anatomic Pathology, Urology and Radiation Oncology, University of California, San Francisco, CA, U.S.A.
authors: Jeffry P
authors: JP
authors: Simko
authors: University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, U.S.A. andrewko@medicine.ucsf.edu.
authors: Andrew H
authors: AH
authors: Ko
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D001549:Benzamides / Q000008:administration & dosage / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy* / Q000601:surgery / Q000821:virology*; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy* / Q000601:surgery / Q000821:virology*; D006515:Hepatitis B virus / Q000502:physiology*; D006801:Humans; D000068877:Imatinib Mesylate; D017114:Liver Failure, Acute / Q000601:surgery / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects*; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects*; D014775:Virus Activation / Q000187:drug effects
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate
keywords: Gastrointestinal stromal cell tumor (GIST); hepatitis B; imatinib; reactivation