title: Incidence and clinical background of hepatitis B virus reactivation in multiple myeloma in novel agents' era.
abstract: There are some reports regarding hepatitis B virus (HBV) reactivation in patients with myeloma who are HBV carriers or who have had a resolved HBV infection, and there is no standard prophylaxis strategy for these patients. We performed a retrospective multicenter study to determine the incidence and characteristics of HBV reactivation in patients with multiple myeloma. We identified 641 patients with multiple myeloma who had been treated using novel agents and/or autologous stem cell transplantation with high-dose chemotherapy between January 2006 and June 2014 at nine Japanese hospitals. The patients' characteristics, laboratory data, and clinical courses were retrieved and statistically analyzed. During a median follow-up of 101 weeks, one of eight (12.5 %) HBV carriers developed hepatitis and 9 of 99 (9.1 %) patients with resolved HBV infection experienced HBV reactivation; the cumulative incidences of HBV reactivation at 2 years (104 weeks) and 5 years (260 weeks) were 8 and 14 %, respectively. The nine cases of reactivation after resolved HBV infection had received entecavir as preemptive therapy or were carefully observed by monitoring their HBV DNA levels, and none of these cases developed hepatitis. Among patients with multiple myeloma, HBV reactivation was not rare. Therefore, long-term monitoring of HBV DNA levels is needed to prevent hepatitis that is related to HBV reactivation in these patients.
authors.affiliation: Department of Hematology, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tsukune
authors.affiliation: Department of Hematology, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. msasaki@juntendo.ac.jp.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sasaki
authors.affiliation: Faculty of Health Science, Daito Bunka University School of Sports and Health Science, Saitama, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Odajima
authors.affiliation: Department of Hematology, National Hospital Organization Nishigunma Hospital, Gunma, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Isoda
authors.affiliation: Department of Hematology, National Hospital Organization Nishigunma Hospital, Gunma, Japan.
authors.forename: Morio
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: Department of Hematology, Juntendo University Shizuoka Hospital, Shizuoka, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Koike
authors.affiliation: Division of Hematology, Department of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Tamura
authors.affiliation: Division of Hematology, Department of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Moriya
authors.affiliation: Department of Medical Oncology, Iwate Medical University School of Medicine, Iwate, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Ito
authors.affiliation: Hematology and Oncology, Department of Internal Medicine, Iwate Medical University School of Medicine, Iwate, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Asahi
authors.affiliation: Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Imai
authors.affiliation: Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Tanaka
authors.affiliation: Department of Medicine and Clinical Science, Gunma University, Gunma, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Handa
authors.affiliation: Infection Control and Prevention Center, Gunma University Hospital, Gunma, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Koiso
authors.affiliation: Department of Hematology, The Fraternity Memorial Hospital, Tokyo, Japan.
authors.forename: Sakae
authors.initials: S
authors.lastname: Tanosaki
authors.affiliation: Department of Hematology, Eiju General Hospital, Tokyo, Japan.
authors.forename: Jian
authors.initials: J
authors.lastname: Hua
authors.affiliation: Department of Hematology, Eiju General Hospital, Tokyo, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Hagihara
authors.affiliation: Department of Hematology, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Yahata
authors.affiliation: Department of Gastroenterology, Tokyo Metropolitan Health and Medical Treatment Corporation Tobu Chiiki Hospital, Tokyo, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Sumio
authors.initials: S
authors.lastname: Watanabe
authors.affiliation: Department of Preventive Medicine, Daito Bunka University Graduate School of Sports and Health Science, Saitama, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sugimori
authors.affiliation: Department of Hematology, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Komatsu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004279:DNA, Viral / Q000032:analysis / Q000235:genetics; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology / Q000821:virology*; D006515:Hepatitis B virus / Q000235:genetics / Q000502:physiology*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D009101:Multiple Myeloma / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000379:methods; D014182:Transplantation, Autologous; D014775:Virus Activation / Q000502:physiology*
chemical_list: D000970:Antineoplastic Agents; D004279:DNA, Viral
keywords: Hepatitis B; Multiple myeloma; Novel agents; Viral reactivation