title: [Efficacy of liver transplantation for acute hepatic failure caused by reactivation of hepatitis B virus infection after chemotherapy and radiotherapy for diffuse large B-cell lymphoma].
abstract: This study was aimed to investigate the morphological, biological ,clinical and therapy features in a special case of primary gastric non-Hodgkin's lymphoma (PG-NHL) through analysis of PG-NHL patient who developed fulminating hepatitis following chemotherapy and radiotherapy and thus received liver transplantation (LT). The morphological changes of cells were analyzed by bone marrow smear, the expression and mutation of abnormal genes were detected by nested multiplex PCR, and HBV-DNA copies were detected by real-time fluorescence quantitative PCR (FQ-PCR). The results showed that at onset of disease, patient was diagnosed as primary gastric non-Hodgkin's lymphoma (PG-NHL) with HBsAg(+) and HBVDNA(-). LUGANO stage was Ia. aaIPI score was 0.The patient was treated with R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone), rituximab maintenance treatment and radiotherapy. During the treatment, the patient has taken entecavir, 1 week later after the radiotherapy (2 months later after the chemotherapy), then the entecavir was discontinued. Six months later HBV DNA(+), the progressive acute hepatic failure (AHF) happened to the patient, who thus received phylogenetic right liver transplantation (LT). He has survived for 3 years after LT so far. The liver function of patient was normal more than 3 years after LT. The patient was checked regularly by PET-CT, and his PG-NHL continue complete remission(CR). It is concluded that the patients receiving chemotherapy or immunosuppressive therapy should be screened for HBV DNA, liver function and HBV reactivation signs. HbsAg positive patients should receive preventive antiviral therapy. After chemotherapy or immunosuppressive therapy, the patients should be given antiviral maintenance therapy, and the liver damage should receive the hepatoprotective and effective support treatment, LT is necessary and feasible to obtain long-term survival.
authors.affiliation: Department of Hematology and Oncology, The Fourth People's Hospital of Jinan, Jinan 250031, Shandong Province, China.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Niu
authors.affiliation: Department of Hematology, Chinese PLA General Hospital, Beijing 100853.
authors.forename: Hua
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Hematology, Gaochun People's Hospital of Nanjing, Gaochun 211300, Jiangsu Province, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Hematology, Chinese PLA General Hospital, Beijing 100853.
authors.forename: Cheng-Ying
authors.initials: CY
authors.lastname: Zhu
authors.affiliation: Department of Hematology, Chinese PLA General Hospital, Beijing 100853.
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Zhu
authors.affiliation: Department of Hematology, Chinese PLA General Hospital, Beijing 100853.
authors.forename: Zi-Long
authors.initials: ZL
authors.lastname: Yao
authors.affiliation: Department of Hematology, Chinese PLA General Hospital, Beijing 100853.
authors.forename: Li
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Hematology, Chinese PLA General Hospital, Beijing 100853. E-mail: jingyu301@126.com.
authors.forename: Yu
authors.initials: Y
authors.lastname: Jing
mesh_terms: D006509:Hepatitis B / Q000150:complications*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus; D006801:Humans; D017114:Liver Failure, Acute / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation; D016403:Lymphoma, Large B-Cell, Diffuse / Q000097:blood / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged
chemical_list: D006514:Hepatitis B Surface Antigens