Hepatitis B reactivation in multiple myeloma patients with resolved hepatitis B undergoing chemotherapy

Lee, Ji Yun; Lim, Sung Hee; Lee, Min Young; Kim, Haesu; Sinn, Dong Hyun; Gwak, Geum Youn; Choi, Moon Seok; Lee, Joon Hyeok; Jung, Chul Won; Jang, Jun Ho; Kim, Won Seog; Kim, Seok Jin; Kım, Kihyun

doi:10.1111/liv.12838

Cited by 22 publications

(33 citation statements)

References 35 publications

(39 reference statements)

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“…). Of the 19 observational studies, 11 were prospective and eight were retrospective . One RCT compared entecavir HBV prophylaxis (before chemotherapy) versus entecavir treatment for HBV reactivation …”

Section: Resultsmentioning

confidence: 99%

Role of surface antibody in hepatitis B reactivation in patients with resolved infection and hematologic malignancy: A meta‐analysis

et al. 2017

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In patients with resolved HBV receiving chemotherapy for hematological malignancies without antiviral prophylaxis, anti-HBs positivity is associated with a decreased risk of reactivation; HBV screening in this patient population should include the routine use of anti-HBs, and those who are anti-HBs-negative should receive antiviral prophylaxis. Future studies should examine the effect of anti-HBs serum titers, the potential role for booster vaccinations, and antiviral prophylaxis prior to chemotherapy in this patient population. (Hepatology 2017;66:379-388).

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Section: Resultsmentioning

confidence: 99%

Role of surface antibody in hepatitis B reactivation in patients with resolved infection and hematologic malignancy: A meta‐analysis

et al. 2017

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“…The precise role of antiviral prophylaxis in patients with resolved HBV who are undergoing ASCT remains controversial [3, 4, 13]. Tsukune et al recommend serial monitoring of HBsAg or HBV DNA as a strategy to detect reactivation [12].…”

Section: Discussionmentioning

confidence: 99%

“…There do appear to be certain risk factors for HBV. Patients with negative anti-HBs seem to be at higher risk of HBV reactivation when compared to patients with a positive anti-HBs [13]. …”

Section: Discussionmentioning

confidence: 99%

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Severe Acute Hepatitis B in HBV-Vaccinated Partner of a Patient with Multiple Myeloma Treated with Cyclophosphamide, Bortezomib, and Dexamethasone and Autologous Stem Cell Transplant

Almaghrabi

Fortinsky

Wong

2017

Case Reports in Hepatology

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Hepatitis B reactivation can occur with various forms of immunosuppression. Cyclophosphamide, Bortezomib, and Dexamethasone (CYBOR-D) chemotherapy is commonly used for the treatment of multiple myeloma and has not been noted in guidelines to be causative in HBV reactivation. Indeed, current guidelines do not recommend providing antiviral prophylaxis to patients with prior HBV infection. We present a case of HBV reactivation as a result of CYBOR-D and autologous stem cell transplant which is complicated by the patient's partner who developed acute hepatitis B. Our case highlights the need to review the role of antiviral prophylaxis for patients undergoing treatment of multiple myeloma and also the role of ensuring immunity for close contacts of these patients who may also be at risk.

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“…With the advent of new therapeutic approaches for malignancies and inflammatory conditions, a flare-up of HBV can occur in apparently inactive HBV carriers. [4][5][6] In many cases, patients with cancer and other pathologies with inactive HBV infection die due to a flare-up of HBV caused by administration of anticancer drugs and immunosuppressants rather than due to their malignancies or autoimmune diseases. Therefore, the management of CHB involves multiple disciplines of medicine.…”

Section: Present Statusmentioning

confidence: 99%

Novel insights into immunotherapy for hepatitis B patients

Akbar

Al‐Mahtab

Jahan

et al. 2015

Expert Review of Gastroenterology & Hepatology

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The possible use of immunotherapy for hepatitis B has emerged for two major reasons: (1) chronic hepatitis B (CHB) is an immune-mediated pathological condition, and (2) commercially available antiviral drugs are of limited efficacy. Although various immunomodulatory agents have been used to treat patients with CHB during the last three decades, there is currently no consensus among physicians and hepatologists regarding the suitability of immunotherapy for patients with CHB. However, new insights into immunotherapy for CHB have emerged; these may facilitate design of effective and tolerable immunotherapy regimens for these patients. This review provides a comprehensive overview of immunotherapy for CHB.

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Hepatitis B reactivation in multiple myeloma patients with resolved hepatitis B undergoing chemotherapy

Abstract: These data show that evaluation of anti-HBc is needed for MM patients, and suggest that monitoring of HBV DNA should be considered for patients with resolved hepatitis B undergoing HDT/ASCT, especially those who are anti-HBs-negative.

Cited by 22 publications

References 35 publications

Role of surface antibody in hepatitis B reactivation in patients with resolved infection and hematologic malignancy: A meta‐analysis

Role of surface antibody in hepatitis B reactivation in patients with resolved infection and hematologic malignancy: A meta‐analysis

Severe Acute Hepatitis B in HBV-Vaccinated Partner of a Patient with Multiple Myeloma Treated with Cyclophosphamide, Bortezomib, and Dexamethasone and Autologous Stem Cell Transplant

Novel insights into immunotherapy for hepatitis B patients

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