title: Reactivation of resolved infection with the hepatitis B virus immune escape mutant G145R during dasatinib treatment for chronic myeloid leukemia.
abstract: Reactivation of hepatitis B virus (HBV) following immunosuppressive therapy or hematopoietic stem cell transplantation is a potentially fatal complication that may occur even in patients with prior resolution of HBV infection. Dasatinib is a small-molecule inhibitor of the tyrosine kinases SRC and ABL that has been approved for the treatment of chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia. Here, we report the first case of reactivation of resolved infection with the HBV immune escape mutant G145R in a CML patient receiving dasatinib. Although dasatinib is not recognized as an immunosuppressant, our observations suggest that dasatinib may enhance HBV replication and induce its reactivation in immunocompetent patients, that HBV escape mutants may contribute to the pathogenesis of HBV reactivation, and that close monitoring of HBV status is advisable in patients with current or resolved HBV infection.
authors.affiliation: Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan, ando1013@gmail.com.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ando
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kojima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Isoda
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Eguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Honda
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Ishigami
authors.forename: Shinya
authors.initials: S
authors.lastname: Kimura
mesh_terms: D000368:Aged; D019943:Amino Acid Substitution; D000069439:Dasatinib / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006509:Hepatitis B / Q000235:genetics / Q000276:immunology; D006515:Hepatitis B virus / Q000502:physiology*; D006801:Humans; D057131:Immune Evasion / Q000187:drug effects / Q000235:genetics; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D020125:Mutation, Missense; D014775:Virus Activation / Q000187:drug effects / Q000235:genetics / Q000276:immunology
chemical_list: D000069439:Dasatinib
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