Skip to main content

Advertisement

Log in

The effectiveness of lamivudine in preventing hepatitis B viral reactivation in rituximab-containing regimen for lymphoma

  • Original Article
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Abstract

In rituximab-containing regimen for lymphoma, the role of lamivudine therapy has not been well established. Therefore, in this nonrandomized phase II clinical study, hepatitis B virus (HBV) carriers with B-cell lymphoma who received rituximab-containing regimen were treated with oral administration of lamivudine. The incidence and severity of hepatitis along with other adverse clinical outcomes were analyzed. Between January 2003 and March 2006, 29 consecutive patients were enrolled. Four of the 29 patients (13.8%) developed hepatitis during chemotherapy, none of which was attributed to HBV reactivation. According to WHO acute toxicity assessment criteria, the severity of hepatitis was grade I in two patients (6.9%) and grade II in two patients (6.9%). In these four patients, only one (3.5%) had interval delay in chemotherapy. No patient had total abnormal bilirubin. No patient had died as the result of hepatitis during the treatment. Interestingly, one of the 29 patients developed HBV activation 5.1 months after the withdrawal of lamivudine. This patient recovered after reinstallation of lamivudine therapy and is still alive. Consequently, our study confirmed previous reports that prophylactic lamivudine therapy can prevent HBV reactivation in HBV carriers who were receiving rituximab-containing regimen for lymphoma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Sun Z, Ming L, Zhu X, Lu J (2002) Prevention and control of hepatitis B in China. J Med Virol 67:447–450

    Article  PubMed  Google Scholar 

  2. Nakamura Y, Motokura T, Fujita A, Yamashita T, Ogata E (1996) Severe hepatitis related to chemotherapy in hepatitis B carriers with hematological malignancies. Cancer 78:2210–2215

    Article  PubMed  CAS  Google Scholar 

  3. Lau JY, Lai CL, Lin HJ, Lok AS, Liang RH, Wu PC et al (1989) Fatal reactivation of chronic hepatitis B virus infection following withdrawal of chemotherapy in lymphoma patients. Q J Med 73:911–917

    PubMed  CAS  Google Scholar 

  4. Lok AS, Liang RH, Chiu EK, Wong KL, Chan TK, Todd D (1991) Reactivation of hepatitis B virus replication in patients receiving cytotoxic therapy. Report of a prospective study. Gastroenterology 100:182–188

    PubMed  CAS  Google Scholar 

  5. Yeo W, Chan PK, Zhong S, Ho WM, Steinberg JL, Tam JS et al (2000) Frequency of hepatitis B virus reactivation in cancer patients undergoing cytotoxic chemotherapy: a prospective study of 626 patients with identification of risk factors. J Med Virol 62:299–307

    Article  PubMed  CAS  Google Scholar 

  6. Kumagai K, Takagi T, Nakamura S, Sawada U, Kura Y, Kodama F et al (1997) Hepatitis B virus carriers in the treatment of malignant lymphoma: an epidemiological study in Japan. Ann Oncol 8(suppl 1):107–109

    Article  PubMed  Google Scholar 

  7. Liang RH, Lok AS, Lai CL, Chan TK, Todd D, Chiu EK (1990) Hepatitis B infection in patients with lymphomas. Hematol Oncol 8:261–270

    Article  PubMed  CAS  Google Scholar 

  8. Liang R, Lau GK, Kwong YL (1999) Chemotherapy and bone marrow transplantation for cancer patients who are also chronic hepatitis B carriers: a review of the problem. J Clin Oncol 17:394–398

    PubMed  CAS  Google Scholar 

  9. Li YH, He YF, Jiang WQ, Wang FH, Lin XB, Zhang L et al (2006) Lamivudine prophylaxis reduces the incidence and severity of hepatitis in hepatitis B virus carriers who receive chemotherapy for lymphoma. Cancer 106:1320–1325

    Article  PubMed  CAS  Google Scholar 

  10. Coiffier B, Lepage E, Briere J, Herbrecht R, Tilly H, Bouabdallah R et al (2002) CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med 346:235–242

    Article  PubMed  CAS  Google Scholar 

  11. van der Kolk LE, Baars JW, Prins MH, van Oers MH et al (2002) Rituximab treatment results in impaired secondary humoral immune responsiveness. Blood 100:2257–2259

    PubMed  CAS  Google Scholar 

  12. Suzan F, Ammor M, Ribrag V (2001) Fatal reactivation of cytomegalovirus infection after use of rituximab for a post-transplantation lymphoproliferative disorder. N Engl J Med 345:1000

    Article  PubMed  CAS  Google Scholar 

  13. Goldberg SL, Pecora AL, Alter RS, Kroll MS, Rowley SD, Waintraub SE et al (2002) Unusual viral infections (progressive multifocal leukoencephalopathy and cytomegalovirus disease) after high-dose chemotherapy with autologous blood stem cell rescue and peritransplantation rituximab. Blood 99:1486–1488

    Article  PubMed  CAS  Google Scholar 

  14. Bermudez A, Marco F, Conde E, Mazo E, Recio M, Zubizarreta A (2000) Fatal visceral varicella-zoster infection following rituximab and chemotherapy treatment in a patient with follicular lymphoma. Haematologica 85:894–895

    PubMed  CAS  Google Scholar 

  15. Ng HJ, Lim LC (2001) Fulminant hepatitis B virus reactivation with concomitant listeriosis after fludarabine and rituximab therapy: case report. Ann Hematol 80:549–552

    Article  PubMed  CAS  Google Scholar 

  16. Tsutsumi Y, Kawamura T, Saitoh S, Yamada M, Obara S, Miura TM et al (2004) Hepatitis B virus reactivation in a case of non-Hodgkin’s lymphoma treated with chemotherapy and rituximab: necessity of prophylaxis for hepatitis B virus reactivation in rituximab therapy. Leuk Lymphoma 45:627–629

    Article  PubMed  Google Scholar 

  17. Sera T, Hiasa Y, Michitaka K, Konishi I, Matsuura K, Tokumoto Y (2006) Anti-HBs-positive liver failure due to hepatitis B virus reactivation induced by rituximab. Intern Med 45:721–724

    Article  PubMed  Google Scholar 

  18. Dervite I, Hober D, Morel P (2001) Acute hepatitis B in a patient with antibodies to hepatitis B surface antigen who was receiving rituximab. N Engl J Med 344:68–69

    Article  PubMed  CAS  Google Scholar 

  19. Skrabs C, Muller C, Agis H, Mannhalter C, Jager U (2002) Treatment of HBV carrying lymphoma patients with rituximab and CHOP: a diagnostic and therapeutic challenge. Leukemia 16:1884–1886

    Article  PubMed  CAS  Google Scholar 

  20. Niscola P, Del Principe MI, Maurillo L, Venditti A, Buccisano F, Piccioni D et al (2005) Fulminant B hepatitis in a surface antigen-negative patient with B-cell chronic lymphocytic leukaemia after rituximab therapy. Leukemia 19:1840–1841

    Article  PubMed  CAS  Google Scholar 

  21. Tsutsumi Y, Tanaka J, Kawamura T, Miura T, Kanamori H, Obara S et al (2004) Possible efficacy of lamivudine treatment to prevent hepatitis B virus reactivation due to rituximab therapy in a patient with non-Hodgkin’s lymphoma. Ann Hematol 83:58–60

    Article  PubMed  CAS  Google Scholar 

  22. Yeo W, Chan PK, Chan HL, Mo FK, Johnson PJ (2001) Hepatitis B virus reactivation during cytotoxic chemotherapy-enhanced viral replication precedes overt hepatitis. J Med Virol 65:473–477

    Article  PubMed  CAS  Google Scholar 

  23. Simon R (1989) Optimal two-stage designs for phase II clinical trials. Control Clin Trials 10:1–10

    Article  PubMed  CAS  Google Scholar 

  24. Tsutsumi Y, Kanamori H, Mori A, Tanaka J, Asaka M, Imamura M, Masauzi N (2005) Reactivation of hepatitis B virus with rituximab. Expert Opin Drug Saf 4:599–608

    Article  PubMed  CAS  Google Scholar 

  25. Mimidis K, Tsatalas C, Margaritis D, Martinis G, Spanoudakis E, Kotsiou S et al (2002) Efficacy of lamivudine in patients with hematologic malignancies receiving chemotherapy and precore mutant chronic active hepatitis B. Acta Haematol 107:49–51

    Article  PubMed  CAS  Google Scholar 

  26. Hamaki T, Kami M, Kusumi E, Ueyama J, Miyakoshi S, Morinaga S, Mutou Y (2001) Prophylaxis of hepatitis B reactivation using lamivudine in a patient receiving rituximab. Am J Hematol 68:292–294

    Article  PubMed  CAS  Google Scholar 

  27. Al-Taie OH, Mörk H, Gassel AM, Wilhelm M, Weissbrich B, Scheurlen M (1999) Prevention of hepatitis B flare-up during chemotherapy using lamivudine: case report and review of the literature. Ann Hematol 78:247–249

    Article  PubMed  CAS  Google Scholar 

  28. Kami M, Hamaki T, Murashige N, Kishi Y, Kusumi E, Yuji K et al (2003) Safety of rituximab in lymphoma patients with hepatitis B or hepatitis C virus infection. Hematol J 4:159–162

    Article  PubMed  CAS  Google Scholar 

  29. Dai MS, Chao TY, Kao WY, Shyu RY, Liu TM (2004) Delayed hepatitis B virus reactivation after cessation of preemptive lamivudine in lymphoma patients treated with rituximab plus CHOP. Ann Hematol 83:769–774

    Article  PubMed  CAS  Google Scholar 

  30. Perceau G, Diris N, Estines O, Derancourt C, Lévy S, Bernard P (2006) Late lethal hepatitis B virus reactivation after rituximab treatment of low-grade cutaneous B-cell lymphoma. Br J Dermatol 155:1053–1056

    Article  PubMed  CAS  Google Scholar 

  31. Hui CK, Cheung WW, Au WY, Lie AK, Zhang HY, Yueng YH et al (2005) Hepatitis B reactivation after withdrawal of pre-emptive lamivudine in patients with hematological malignancy on completion of cytotoxic chemotherapy. Gut 54:1597–1603

    Article  PubMed  CAS  Google Scholar 

  32. Ling R, Mutimer D, Ahmed M, Boxall EH, Elias E, Dusheiko GM, Harrison TJ (1996) Selection of mutation in the hepatitis B virus polymerase during therapy of transplant recipients with lamivudine. Hepatology 24:711–713

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yu-Hong Li.

Rights and permissions

Reprints and permissions

About this article

Cite this article

He, YF., Li, YH., Wang, FH. et al. The effectiveness of lamivudine in preventing hepatitis B viral reactivation in rituximab-containing regimen for lymphoma. Ann Hematol 87, 481–485 (2008). https://doi.org/10.1007/s00277-008-0454-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00277-008-0454-3

Keywords

Navigation