Incidence and risk factors of hepatitis B virus reactivation in patients with multiple myeloma in an era with novel agents: a nationwide retrospective study in Japan

Tsukune, Yutaka; Sasaki, Makoto; Odajima, Takeshi; Sunami, Kazutaka; Takei, Tomomi; Moriuchi, Yukiyoshi; Iino, Masaki; Isoda, Atsushi; Nakaya, Aya; Muta, Tsuyoshi; Miyake, Toru; Miyazaki, Kôji; Shioiri, Takayuki; Nakajima, Kei; Igarashi, Aiko; Nagafuji, Koji; Kurihara, Taro; Aoyama, Tomonori; Sugimori, Hiroki; Komatsu, Norio

doi:10.1038/s41408-017-0002-2

Cited by 18 publications

(20 citation statements)

References 15 publications

(22 reference statements)

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“…Of note, a Japanese multicenter retrospective study suggested that lenalidomide can reduce the risk of HBV reactivation during the treatment of multiple myeloma. 12 DARA can potentially increase the risk of viral infection, 5 but the pathogenesis is unclear. DARA is an IgG1 kappa monoclonal antibody targeting CD38 that that is expressed not only in myeloma cells, but also in non-malignant T cells, natural killer (NK) cells, B cells, and plasma cells.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis B virus reactivation in a myeloma patient with resolved infection who received daratumumab-containing salvage chemotherapy

Kikuchi

Kusumoto

Tanaka

et al. 2020

J Clin Exp Hematopathol

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Section: Discussionmentioning

confidence: 99%

Hepatitis B virus reactivation in a myeloma patient with resolved infection who received daratumumab-containing salvage chemotherapy

Kikuchi

Kusumoto

Tanaka

et al. 2020

J Clin Exp Hematopathol

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“…It is well-established that rituximab-containing regimens, mainly rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), are strongly linked to a high risk of HBV reactivation 2,4,15 . However, in recent years other chemotherapy schemes, such as those for multiple myeloma, have also been associated with a risk of HBV reactivation 16,17 . In our cohort, the malignancy associated with the lowest screening rate was CML.…”

Section: Discussionmentioning

confidence: 99%

An electronic alert system increases screening for hepatitis B and C and improves management of patients with haematological disorders

Riveiro‐Barciela

Gubern

Roade

et al. 2020

Sci Rep

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treatment of haematological disorders in patients with chronic hepatitis B or resolved infection (anti-HBc-positive) is associated with a risk of hepatitis B reactivation. Moreover, patients with chronic hepatitis C have a higher risk of haematological malignancies than general population. An electronic alert system was developed to promote screening of hepatitis B (HBV) and c (HcV) in patients starting haematological therapies. The system included screening and linkage to care and a request for testing in those without data. From March, 2017 to March, 2018 data from 420 consecutive patients with haematological diseases were included. At first prescription before the alerts, the HCV and HBV screening rate was 60.5%. Following the alerts, an additional 115 were screened, increasing the overall screening rate to 87.9%. Anti-HBc alone was detected in 57, anti-HCV in 13, and HBsAg in 2 patients. Overall, 68% of patients with any viral hepatitis markers were previously not know, and the impact was particularly important for anti-HBc detection (47/57 unknown). Nucleoside analogues were prescribed in 28 (49.1%) anti-HBc-positive and the 2 HBsAg-positive patients. Prospective follow-up with HBV DNA and HBsAg testing showed no cases of HBV reactivation. An estimated 1.2 HBV reactivations were avoided as consequence of the alert system. In summary, an electronic alert system increased viral hepatitis screening in patients receiving haematological treatment and led to improvements in the management of these patients, including avoided HBV reactivation.

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“…In two retrospective studies performed in multiple myeloma patients who received a sequential bortezomib-containing induction therapy and auto-HSCT, it was found that the positivity for HBsAg was an independent risk factor for overall survival [105,106]. A nationwide retrospective study in Japan showed that auto-HSCT was an independent risk factor for HBVr in patients with resolved HBV infection [107]. The cumulative incidence of HBVr in patients with auto-HSCT at 2 and 5 years was 16% and 30.6%, respectively [107].…”

Section: Management Of Hbv Reactivationmentioning

confidence: 99%

“…A nationwide retrospective study in Japan showed that auto-HSCT was an independent risk factor for HBVr in patients with resolved HBV infection [107]. The cumulative incidence of HBVr in patients with auto-HSCT at 2 and 5 years was 16% and 30.6%, respectively [107]. A multivariate analysis revealed that auto-HSCT was independently associated with a high prevalence of HBVr; in contrast, lenalidomide significantly decreased the incidence of HBVr.…”

Section: Management Of Hbv Reactivationmentioning

confidence: 99%

HBV Reactivation in Patients Undergoing Hematopoietic Stem Cell Transplantation: A Narrative Review

Gentile

Antonelli

2019

Viruses

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HBV reactivation (HBVr) can occur due to the ability of HBV to remain latent in the liver as covalently closed circular DNA and by the capacity of HBV to alter the immune system of the infected individuals. HBVr can occur in patients undergoing hematopoietic stem cell transplantation (HSCT) with a clinical spectrum that ranges from asymptomatic infection to fulminant hepatic failure. The risk of HBVr is determined by a complex interplay between host immunity, virus factors, and immunosuppression related to HSCT. All individuals who undergo HSCT should be screened for HBV. HSCT patients positive for HBsAg and also those HBcAb-positive/HBsAg-negative are at high risk of HBV reactivation (HBVr) due to profound and prolonged immunosuppression. Antiviral prophylaxis prevents HBVr, decreases HBVr-related morbidity and mortality in patients with chronic or previous HBV. The optimal duration of antiviral prophylaxis remains to be elucidated. The vaccination of HBV-naïve recipients and their donors against HBV prior to HSCT has an important role in the prevention of acquired HBV infection. This narrative review provides a comprehensive update on the current concepts, risk factors, molecular mechanisms, prevention, and management of HBVr in HSCT.

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Incidence and risk factors of hepatitis B virus reactivation in patients with multiple myeloma in an era with novel agents: a nationwide retrospective study in Japan

Cited by 18 publications

References 15 publications

Hepatitis B virus reactivation in a myeloma patient with resolved infection who received daratumumab-containing salvage chemotherapy

Hepatitis B virus reactivation in a myeloma patient with resolved infection who received daratumumab-containing salvage chemotherapy

An electronic alert system increases screening for hepatitis B and C and improves management of patients with haematological disorders

HBV Reactivation in Patients Undergoing Hematopoietic Stem Cell Transplantation: A Narrative Review

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