Reactivation of DNA viruses in association with histone deacetylase inhibitor therapy: a case series report

Haematologica. 2009 Nov;94(11):1618-22. doi: 10.3324/haematol.2009.008607. Epub 2009 Jul 16.

Abstract

Histone deacetylase inhibitors are a class of anti-neoplastic agents that induce growth arrest, differentiation, and/or apoptotic cell death of transformed cells in vitro and in vivo. A phase II study exploring the efficacy of romidepsin, an histone deacetylase inhibitor, in patients with cutaneous or peripheral T-cell lymphomas was initiated at the National Cancer Institute. To date, over 120 patients with T-cell lymphoma have been treated on a multi-institutional phase II trial of romidepsin. Reactivation of latent DNA viruses including EBV, HBV, and VZV is well described as a consequence of the immune suppression associated with systemic chemotherapy. The incidence of viral reactivation in patients treated with histone deacetylase inhibitors is not yet known. We report the observation of EBV-associated illnesses in 2 patients and the reactivation of HBV in an additional patient treated with romidepsin. These cases may represent reactivation of DNA viruses due to histone deacetylase inhibitor induced immunosuppression, or direct promotion of viral replication via histone deacetylase inhibitor induced chromatin remodeling, or, alternatively, may be related to the underlying disease process. These observations suggest that vigilance for DNA virus reactivation is needed to quantify the risk in patients treated with histone deacetylase inhibitors.

Publication types

  • Case Reports
  • Clinical Trial, Phase II
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Antibiotics, Antineoplastic / adverse effects*
  • DNA Viruses / physiology*
  • Depsipeptides / adverse effects*
  • Female
  • Histone Deacetylase Inhibitors / adverse effects*
  • Histone Deacetylase Inhibitors / therapeutic use
  • Humans
  • Lymphoma, T-Cell, Peripheral / complications
  • Lymphoma, T-Cell, Peripheral / drug therapy
  • Male
  • Middle Aged
  • Skin Neoplasms / complications
  • Skin Neoplasms / drug therapy
  • Virus Activation / drug effects*

Substances

  • Antibiotics, Antineoplastic
  • Depsipeptides
  • Histone Deacetylase Inhibitors
  • romidepsin