Abstract
A patient with stage IV non-Hodgkin's lymphoma and chronic hepatitis who was treated with chemotherapy and rituximab developed fatal reactivation of hepatitis B. High viral load titers of hepatitis B DNA were demonstrated. DNA sequencing analysis revealed the presence of the precore mutant strain. Hepatitis B reactivation in patients receiving rituxmab-based chemotherapy is reviewed and the role of precore mutant virus strains resulting in fatal complications is discussed.
MeSH terms
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Adult
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Antibodies, Monoclonal / administration & dosage
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Antibodies, Monoclonal / adverse effects
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Antibodies, Monoclonal, Murine-Derived
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Antineoplastic Combined Chemotherapy Protocols / administration & dosage
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Antineoplastic Combined Chemotherapy Protocols / adverse effects*
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Cyclophosphamide / administration & dosage
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Cyclophosphamide / adverse effects
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Doxorubicin / administration & dosage
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Doxorubicin / adverse effects
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Fatal Outcome
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Hepatitis B / chemically induced*
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Hepatitis B / virology
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Hepatitis B virus / drug effects
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Hepatitis B virus / physiology
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Humans
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Lymphoma, Non-Hodgkin / drug therapy*
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Lymphoma, Non-Hodgkin / pathology
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Male
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Neoplasm Staging
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Prednisone / administration & dosage
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Prednisone / adverse effects
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Recurrence
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Rituximab
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Vincristine / administration & dosage
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Vincristine / adverse effects
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Virus Activation / drug effects*
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Murine-Derived
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Rituximab
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Vincristine
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Doxorubicin
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Cyclophosphamide
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Prednisone