1. Incidence and clinical background of hepatitis B virus reactivation in multiple myeloma in novel agents' era
- Author
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Yoichi Imai, Shigeki Ito, Keiichi Moriya, Sakae Tanosaki, Hiromi Koiso, Yuriko Yahata, Jian Hua, Takeshi Odajima, Atsushi Isoda, Yutaka Tsukune, Satoko Suzuki, Makoto Sasaki, Michiaki Koike, Hiroki Sugimori, Masao Hagihara, Junji Tanaka, Sumio Watanabe, Norio Komatsu, Hideto Tamura, Morio Matsumoto, Maki Asahi, and Hiroshi Handa
- Subjects
Male ,medicine.medical_specialty ,Hepatitis B virus ,Antineoplastic Agents ,medicine.disease_cause ,Real-Time Polymerase Chain Reaction ,Gastroenterology ,Transplantation, Autologous ,03 medical and health sciences ,0302 clinical medicine ,Autologous stem-cell transplantation ,Japan ,Internal medicine ,medicine ,Humans ,Multiple myeloma ,Aged ,Retrospective Studies ,Hepatitis ,Aged, 80 and over ,Hematology ,business.industry ,Incidence (epidemiology) ,Incidence ,virus diseases ,General Medicine ,Entecavir ,Hepatitis B ,medicine.disease ,Combined Modality Therapy ,digestive system diseases ,030220 oncology & carcinogenesis ,Immunology ,DNA, Viral ,030211 gastroenterology & hepatology ,Female ,Virus Activation ,business ,Multiple Myeloma ,medicine.drug ,Stem Cell Transplantation - Abstract
There are some reports regarding hepatitis B virus (HBV) reactivation in patients with myeloma who are HBV carriers or who have had a resolved HBV infection, and there is no standard prophylaxis strategy for these patients. We performed a retrospective multicenter study to determine the incidence and characteristics of HBV reactivation in patients with multiple myeloma. We identified 641 patients with multiple myeloma who had been treated using novel agents and/or autologous stem cell transplantation with high-dose chemotherapy between January 2006 and June 2014 at nine Japanese hospitals. The patients’ characteristics, laboratory data, and clinical courses were retrieved and statistically analyzed. During a median follow-up of 101 weeks, one of eight (12.5 %) HBV carriers developed hepatitis and 9 of 99 (9.1 %) patients with resolved HBV infection experienced HBV reactivation; the cumulative incidences of HBV reactivation at 2 years (104 weeks) and 5 years (260 weeks) were 8 and 14 %, respectively. The nine cases of reactivation after resolved HBV infection had received entecavir as preemptive therapy or were carefully observed by monitoring their HBV DNA levels, and none of these cases developed hepatitis. Among patients with multiple myeloma, HBV reactivation was not rare. Therefore, long-term monitoring of HBV DNA levels is needed to prevent hepatitis that is related to HBV reactivation in these patients.
- Published
- 2016