Fatal reactivation of hepatitis B post-chemotherapy for lymphoma in a hepatitis B surface antigen-negative, hepatitis B core antibody-positive patient: Potential implications for future prophylaxis recommendations

Joanna K. Law, Jin K. Ho, Paul J. Hoskins, Siegfried R. Erb, Urs P. Steinbrecher, Eric M. Yoshida

Research output: Contribution to journalArticle

Abstract

In the absence of prophylaxis, the reactivation of hepatitis B in oncology patients who are hepatitis B carriers is a well-known and often fatal complication of chemotherapy. The current recommendations in Canada and the USA are that patients who are positive for hepatitis B surface antigen (HBsAg) receive antiviral prophylaxis prior to chemotherapy. We report a 67-year-old man with B-cell lymphoma who developed hepatitis B reactivation following chemotherapy with cyclophosphamide, adriamycin, vincristine, prednisone and rituximab. Pre-chemotherapy, the patient was negative for HBsAg, positive for hepatitis B core antibody (anti-HBc) and weakly positive for hepatitis B surface antibody. Despite treatment with lamivudine, the patient died of fulminant hepatic failure. Our experience indicates that patients who are negative for HBsAg but positive for anti-HBc are still at risk for reactivation of latent hepatitis B during and after chemotherapy and may be considered for prophylaxis.

Original languageEnglish (US)
Pages (from-to)1085-1089
Number of pages5
JournalLeukemia and Lymphoma
Volume46
Issue number7
DOIs
StatePublished - 2005
Externally publishedYes

Fingerprint

Hepatitis B Antibodies
Hepatitis B Surface Antigens
Hepatitis B
Lymphoma
Drug Therapy
Lamivudine
Acute Liver Failure
Vincristine
B-Cell Lymphoma
Prednisone
Doxorubicin
Cyclophosphamide
Canada
Antiviral Agents

Keywords

  • Chemotherapy
  • Core antibody
  • Hepatitis B
  • Lymphoma
  • Reactivation
  • Surface antigen

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Fatal reactivation of hepatitis B post-chemotherapy for lymphoma in a hepatitis B surface antigen-negative, hepatitis B core antibody-positive patient : Potential implications for future prophylaxis recommendations. / Law, Joanna K.; Ho, Jin K.; Hoskins, Paul J.; Erb, Siegfried R.; Steinbrecher, Urs P.; Yoshida, Eric M.

In: Leukemia and Lymphoma, Vol. 46, No. 7, 2005, p. 1085-1089.

Research output: Contribution to journalArticle

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