Efficacy of prophylactic lamivudine to prevent hepatitis B virus reactivation in B-cell lymphoma treated with rituximab-containing chemotherapy

Support Care Cancer. 2013 May;21(5):1265-71. doi: 10.1007/s00520-012-1656-8. Epub 2012 Nov 15.

Abstract

Purpose: Reactivation of hepatitis B virus (HBV) is a common complication in patients with HBV infection who receive cytotoxic chemotherapy. In rituximab-containing chemotherapy for B-cell lymphoma, severe hepatitis due to HBV reactivation occurred. The aim of this study is to estimate the effect of prophylactic lamivudine on the risk of HBV reactivation in patients with HBV infection who receive rituximab-containing chemotherapy.

Methods: In this study, HBV markers and liver function tests were monitored in 268 consecutive patients with B-cell lymphoma, who received rituximab-containing chemotherapy between January 2008 and November 2011. Sixty-nine patients (25.7 %) with either chronic HBV infection or past HBV infection received prophylaxis with lamivudine 100 mg daily by oral intake.

Results: In the HBsAg-positive group, six (6/38) patients developed hepatitis, only one of which was attributed to HBV reactivation. In the HBsAg-negative and HBcAb-positive group, two (2/31) patients developed hepatitis, none of which was attributed to HBV reactivation.

Conclusions: These results support that prophylactic lamivudine can prevent HBV reactivation for B-cell lymphoma with HBV infection who was receiving rituximab-containing chemotherapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Murine-Derived / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Female
  • Hepatitis B / prevention & control*
  • Hepatitis B Surface Antigens / blood
  • Humans
  • Lamivudine / therapeutic use*
  • Liver Function Tests
  • Lymphoma, B-Cell / drug therapy*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Reverse Transcriptase Inhibitors / therapeutic use
  • Rituximab
  • Virus Activation / drug effects

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Hepatitis B Surface Antigens
  • Reverse Transcriptase Inhibitors
  • Lamivudine
  • Rituximab