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Long-term outcome after prophylactic lamivudine treatment on hepatitis B virus reactivation in non-Hodgkin's lymphoma.

Authors
 Jin Seok Kim  ;  Jee Sook Hahn  ;  Yoo Hong Min  ;  Seung Tae Lee  ;  June-Won Cheong  ;  Chun Kyon Lee  ;  In Hae Park  ;  Yuri Kim  ;  Sun Young Park 
Citation
 Yonsei Medical Journal, Vol.48(1) : 78-89, 2007 
Journal Title
 Yonsei Medical Journal 
ISSN
 0513-5796 
Issue Date
2007
Abstract
Hepatitis B virus (HBV) reactivation is the frequent complication after cytotoxic chemotherapy in HBsAg-positive non-Hodgkin's lymphoma (NHL) patients. Pre-chemotherapy viral load may be a risk factor and HBeAg-positive status is associated with increased viral load. The aim of this study was to investigate the long-term treatment outcome of lamivudine in preventing HBV reactivation and its associated morbidity according to HBeAg status. Twenty-four adult HBsAg-positive NHL patients were taken 100 mg of lamivudine daily before the initiation of chemotherapy. The median duration of lamivudine therapy was 11.5 months (range: 1-54 months) and the median number of chemotherapy cycles was 6 (range: 1-16 cycles). The steroid containing chemotherapy regimens were used in 18 patients (75%), and the anti-CD20 monoclonal antibody containing chemotherapy regimen was used in 6 patients (25%). Four patients received autologous peripheral blood stem cell transplantation without resultant HBV reactivation. Hepatitis related to HBV reactivation was developed in 1 patient among 14 HBeAg-positive patients and no one among 10 HBeAg-negative. One patient developed HBV reactivation after lamivudine withdrawal, and 4 patients developed the YMDD (tyrosine-methionine-aspartate-aspartate) mutation during lamivudine therapy. There were no statistical differences in HBV reactivation rate during chemotherapy according to the HBeAg status. Our results demonstrate that lamivudine should be considered preemptively before the chemotherapy for all HBsAg-positive NHL patients to prevent HBV reactivation, regardless of pre-chemotherapy HBeAg status. Finally, compared with the chronic hepatitis B patients, similar rate of HBV reactivation after lamivudine withdrawal and development of YMDD mutation was observed in NHL patients.
Files in This Item:
T200701626.pdf Download
DOI
10.3349/ymj.2007.48.1.78
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김유리(Kim, Yu Ri) ORCID logo https://orcid.org/0000-0001-5505-0142
김진석(Kim, Jin Seok) ORCID logo https://orcid.org/0000-0001-8986-8436
민유홍(Min, Yoo Hong) ORCID logo https://orcid.org/0000-0001-8542-9583
박선영(Park, Sun Young)
박인혜(Park, In Hae)
이승태(Lee, Seung Tae)
이천균(Lee, Chun Kyon)
정준원(Cheong, June-Won) ORCID logo https://orcid.org/0000-0002-1744-0921
한지숙(Hahn, Jee Sook)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/97570
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