Abstract
Background Rituximab-containing chemotherapies are offered to elderlies for treatment of non-Hodgkin lymphomas (NHL). From 0.7 to 27% of patients with “resolved” HBV infection develop HBV reactivation and related hepatitis during Rituximab-containing chemotherapies. Currently, several antiviral drugs are available for the prophylaxis of patients at risk for HBV reactivation, which include lamivudine, tenofovir, entecavir, and adefovir. Viral breakthrough may occur during therapy, which is defined as an abrupt increase in serum HBV DNA levels after a period of persistent suppression. Viral breakthrough occurs with non-compliance to therapy and, also, when drug-resistant mutants emerge. The risk might be higher in fragile patients as elderlies. Aims Since no study addressed this question, we determined the rate of HBV-RS in patients >65 years undergoing Rituximab-containing chemotherapies for NHLs. Methods We evaluated 85 newly diagnosed NHL patients with resolved HBV infection, receiving Rituximab-containing chemotherapies. All received lamivudine. HBV DNA was checked at baseline, every 4 weeks, for 1 year after completion of Rituximab cointaining regimens. Results Nine patients (10%) had HBV reactivation and HBV related hepatitis. All received entecavir and recovered without consequences. HBV reactivation was more likely to occur after an average of five R-CHOP cycles or during Fludarabine. Conclusions The rate of viral breakthrough (VBK), in our study population, is high considering that the patients were HBV DNA negative at baseline and suggest that Lamivudine prevention may not be sufficient in this population.
| Original language | English |
|---|---|
| Pages (from-to) | 1394-1397 |
| Number of pages | 4 |
| Journal | Digestive and Liver Disease |
| Volume | 48 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - Nov 1 2016 |
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Keywords
- Elderlies
- HBV reactivation
- Non-Hodgkin lymphomas (NHLs)
- Rituximab-containing chemotherapies
ASJC Scopus subject areas
- Hepatology
- Gastroenterology
Cite this
High rate of hepatitis B viral breakthrough in elderly non-Hodgkin lymphomas patients treated with Rituximab based chemotherapy. / Castelli, Roberto; Ferraris, Laurenzia; Pantaleo, Giuseppe; Lambertenghi Deliliers, Giorgio; Cicardi, Marco.
In: Digestive and Liver Disease, Vol. 48, No. 11, 01.11.2016, p. 1394-1397.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - High rate of hepatitis B viral breakthrough in elderly non-Hodgkin lymphomas patients treated with Rituximab based chemotherapy
AU - Castelli, Roberto
AU - Ferraris, Laurenzia
AU - Pantaleo, Giuseppe
AU - Lambertenghi Deliliers, Giorgio
AU - Cicardi, Marco
PY - 2016/11/1
Y1 - 2016/11/1
N2 - Background Rituximab-containing chemotherapies are offered to elderlies for treatment of non-Hodgkin lymphomas (NHL). From 0.7 to 27% of patients with “resolved” HBV infection develop HBV reactivation and related hepatitis during Rituximab-containing chemotherapies. Currently, several antiviral drugs are available for the prophylaxis of patients at risk for HBV reactivation, which include lamivudine, tenofovir, entecavir, and adefovir. Viral breakthrough may occur during therapy, which is defined as an abrupt increase in serum HBV DNA levels after a period of persistent suppression. Viral breakthrough occurs with non-compliance to therapy and, also, when drug-resistant mutants emerge. The risk might be higher in fragile patients as elderlies. Aims Since no study addressed this question, we determined the rate of HBV-RS in patients >65 years undergoing Rituximab-containing chemotherapies for NHLs. Methods We evaluated 85 newly diagnosed NHL patients with resolved HBV infection, receiving Rituximab-containing chemotherapies. All received lamivudine. HBV DNA was checked at baseline, every 4 weeks, for 1 year after completion of Rituximab cointaining regimens. Results Nine patients (10%) had HBV reactivation and HBV related hepatitis. All received entecavir and recovered without consequences. HBV reactivation was more likely to occur after an average of five R-CHOP cycles or during Fludarabine. Conclusions The rate of viral breakthrough (VBK), in our study population, is high considering that the patients were HBV DNA negative at baseline and suggest that Lamivudine prevention may not be sufficient in this population.
AB - Background Rituximab-containing chemotherapies are offered to elderlies for treatment of non-Hodgkin lymphomas (NHL). From 0.7 to 27% of patients with “resolved” HBV infection develop HBV reactivation and related hepatitis during Rituximab-containing chemotherapies. Currently, several antiviral drugs are available for the prophylaxis of patients at risk for HBV reactivation, which include lamivudine, tenofovir, entecavir, and adefovir. Viral breakthrough may occur during therapy, which is defined as an abrupt increase in serum HBV DNA levels after a period of persistent suppression. Viral breakthrough occurs with non-compliance to therapy and, also, when drug-resistant mutants emerge. The risk might be higher in fragile patients as elderlies. Aims Since no study addressed this question, we determined the rate of HBV-RS in patients >65 years undergoing Rituximab-containing chemotherapies for NHLs. Methods We evaluated 85 newly diagnosed NHL patients with resolved HBV infection, receiving Rituximab-containing chemotherapies. All received lamivudine. HBV DNA was checked at baseline, every 4 weeks, for 1 year after completion of Rituximab cointaining regimens. Results Nine patients (10%) had HBV reactivation and HBV related hepatitis. All received entecavir and recovered without consequences. HBV reactivation was more likely to occur after an average of five R-CHOP cycles or during Fludarabine. Conclusions The rate of viral breakthrough (VBK), in our study population, is high considering that the patients were HBV DNA negative at baseline and suggest that Lamivudine prevention may not be sufficient in this population.
KW - Elderlies
KW - HBV reactivation
KW - Non-Hodgkin lymphomas (NHLs)
KW - Rituximab-containing chemotherapies
UR - http://www.scopus.com/inward/record.url?scp=84992520887&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84992520887&partnerID=8YFLogxK
U2 - 10.1016/j.dld.2016.08.113
DO - 10.1016/j.dld.2016.08.113
M3 - Article
AN - SCOPUS:84992520887
VL - 48
SP - 1394
EP - 1397
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 11
ER -