Prophylactic Use of Entecavir for Lymphoma Patients With Past Hepatitis B Virus Infection: A Randomized Controlled Trial

Liu, Wei Ping; Xiao, Xiu Bin; Xue, Mei; Wang, Gui Qiang; Wang, Xiao Pei; Song, Yinggai; Zhu, Jun

doi:10.1016/j.clml.2018.11.008

Cited by 14 publications

(24 citation statements)

References 26 publications

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“…Antiviral agents may be used as prophylaxis in patients who do not require antiviral therapy. In the previously described Chinese study [40], the incidence rates of HBV reactivation and HBV reactivation-related hepatitis in the prophylactic antiviral therapy group were not significantly higher than those in the preemptive therapy group. This study also assessed cost-effectiveness.…”

Section: The Prophylactic Strategy For Hbv Reactivation In MM Patimentioning

confidence: 89%

“…HBV reactivation has been analyzed in four large-scale prospective studies of patients with malignant lymphoma and resolved HBV infection who received chemotherapy with or without rituximab [16,17,18,40] (Table 3). The Taiwan Cooperative Oncology Group conducted a prospective study of 150 HBsAg-negative lymphoma patients receiving rituximab-CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone)-based chemotherapy [16].…”

Section: Hbv Reactivationmentioning

confidence: 99%

“…Recently, a Chinese group reported a prospective randomized controlled study for patients with malignant lymphoma and resolved HBV infection, to evaluate the efficacy and safety of ETV prophylaxis [40]. Patients were randomly assigned in a 1:1 ratio to either a prophylactic ETV group or a preemptive therapy group.…”

Section: Hbv Reactivationmentioning

confidence: 99%

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Reactivation of Hepatitis B Virus in Patients with Multiple Myeloma

Tsukune

Sasaki

Komatsu

2019

Cancers

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Reactivation of hepatitis B virus (HBV) is a well-known complication in patients with hematological malignancies during or after cytotoxic chemotherapy. If the initiation of antiviral therapy is delayed in patients with HBV reactivation, these patients can develop severe hepatitis and may die of fulminant hepatitis. The preventive strategy for HBV reactivation in patients with malignant lymphoma has already been established based on some prospective studies. As there was an increased number of novel agents being approved for the treatment of multiple myeloma (MM), the number of reported cases of HBV reactivation among MM patients has gradually increased. We conducted a Japanese nationwide retrospective study and revealed that HBV reactivation in MM patients is not rare and that autologous stem cell transplantation is a significant risk factor. In this study, around 20% of all patients with HBV reactivation developed HBV reactivation after 2 years from the initiation of therapy, unlike malignant lymphoma. This might be due to the fact that almost all of the patients received chemotherapy for a long duration. Therefore, a new strategy for the prevention of HBV reactivation in MM patients is required.

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Section: The Prophylactic Strategy For Hbv Reactivation In MM Patimentioning

confidence: 89%

Section: Hbv Reactivationmentioning

confidence: 99%

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Reactivation of Hepatitis B Virus in Patients with Multiple Myeloma

Tsukune

Sasaki

Komatsu

2019

Cancers

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“…The use of third generation antivirals in pOBI is on the contrary questionable and debated. Recent prospective data from China, suggest that this strategy might not even be cost effective, especially in patients with low HBVr risk such as those in whom anti-HBs antibodies are present, and that a preemptive approach based on virological surveillance might thus prevent unnecessary prophylaxis in a large percentage of patients of this subgroup (96.8%) [83]. The latest 2017 EASL guidelines regarding the management of HBV infection indicate that all HBsAg-positive patients (AC, IC) should receive third-generation NUCs as treatment or prophylaxis (evidence level II-2, grade of recommendation 1), while HBsAg-negative/anti-HBc positive subjects (pOBI) should receive anti-HBV prophylaxis if at high risk of HBV reactivation (evidence level II-2, grade of recommendation1) according to GRADE system [33].…”

Section: Management Of Patients With Hm and Serological Signs Of Cmentioning

confidence: 99%

Hematological Malignancies and HBV Reactivation Risk: Suggestions for Clinical Management

Zannella

Marignani

Begini

2019

Viruses

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It is well known that hepatitis B virus reactivation (HBVr) can occur among patients undergoing treatment for hematological malignancies (HM). The evaluation of HBVr risk in patients undergoing immunosuppressive treatments is a multidimensional process, which includes conducting an accurate clinical history and physical examination, consideration of the virological categories, of the medication chosen to treat these hematological malignancies and the degree of immunosuppression induced. Once the risk of reactivation has been defined, it is crucial to adopt adequate management strategies (should reactivation occur). The purpose of treatment is to prevent dire clinical consequences of HBVr such as acute/fulminant hepatitis, and liver failure. Treatment will be instituted according to the indications and evidence provided by current international recommendations and to prevent interruption of lifesaving anti-neoplastic treatments. In this paper, we will present the available data regarding the risk of HBVr in this special population of immunosuppressed patients and explore the relevance of effective prevention and management of this potentially life-threatening event. A computerized literature search was performed using appropriate terms to discover relevant articles. Current evidence supports the policy of universal HBV testing of patients scheduled to undergo treatment for hematological malignancies, and clinicians should be aware of the inherent risk of viral reactivation among the different virological categories and classes of immunosuppressive drugs.

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“…15 Liu et al reported that lymphoma patients receiving rituximab taking prophylactic entecavir had no HBV reactivation or related hepatitis. 16 The issue of chemotherapy-induced HBV reactivation has gained attention in Taiwan in recent years. Two studies published in 2018 discussed the prevalence of HBV reactivation in Taiwan.…”

Section: Introductionmentioning

confidence: 99%

Real-world prevalence of hepatitis B virus reactivation in cancer patients in Taiwan

Chen

Hsieh

2020

J Oncol Pharm Pract

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Background Hepatitis B virus carriers who receive systemic cancer chemotherapy have been found to be at a higher risk of hepatitis B virus reactivation. However, lack of standard prophylaxis protocol resulted in life-threatening adverse events. Objective This retrospective study is to investigate prevalence and chemotherapy drug-induced hepatitis B virus reactivation in all types of cancer patients and establish an institutional clinical practice protocol. Methodology: This retrospective cohort study evaluated the incidence of hepatitis B virus infection, the pre-chemotherapy screening rate of hepatitis B surface antigen (HBsAg), and the severity of hepatitis B virus reactivation of cancer patients receiving intravenous chemotherapy between 2013 and 2014. Patients receiving local chemotherapy with intra-cavity instillation, drug- or alcohol-related hepatitis, or chemotherapy for immune diseases were excluded. Results In total 784 patients, 404 patients (51.53%) underwent hepatitis B virus serum antigen (HBsAg) testing before chemotherapy, and 61 patients (7.78%) tested positive. Only 32 patients (4.08%) received prophylactic hepatitis B virus antiviral therapy. Patients receiving prophylactic antiviral drugs were significantly lower risk of hepatitis B virus reactivation than nonprophylaxis (relative risk, RR: 0.53, number needed to treat, NNT: 12). Moreover, our study found specific single or combined chemotherapy that may cause hepatitis B virus reactivation different from those of other studies conducted in Western countries. The differences may refer to enzymes, proteins and immune response of patients. Conclusions Our findings indicate that cancer patients receiving prophylactic antiviral drugs remain at risk of hepatitis B virus reactivation during chemotherapy. Therefore, the hepatitis B virus screen and chemotherapy control system was established in 2017 to reduce the risk of hepatitis B virus reactivation and improve patient safety.

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Prophylactic Use of Entecavir for Lymphoma Patients With Past Hepatitis B Virus Infection: A Randomized Controlled Trial

Cited by 14 publications

References 26 publications

Reactivation of Hepatitis B Virus in Patients with Multiple Myeloma

Reactivation of Hepatitis B Virus in Patients with Multiple Myeloma

Hematological Malignancies and HBV Reactivation Risk: Suggestions for Clinical Management

Real-world prevalence of hepatitis B virus reactivation in cancer patients in Taiwan

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