Uchida N, Gondo H, Himeji D, Kaji Y, Sata M, Niho Y
First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Bone Marrow Transplant. 2000 Dec;26(11):1243-5. doi: 10.1038/sj.bmt.1702693.
Hepatitis B virus (HBV) can be a cause of fatal liver failure after chemotherapy for viral carrier patients and limits the indication of myeloablative therapy for them. We describe an HBsAg-positive leukemia patient who successfully underwent autologous PBSC transplant. After chemotherapeutic treatment his serum HBV DNA level rose in association with hepatitis. To prevent progression to fulminant hepatitis, we administered lamivudine, a viral reverse transcriptase inhibitor, during the transplantation procedure. The patient did not show any increase of HBV DNA or a worsening of his hepatitis. Thus, lamivudine may be a promising treatment for HBsAg-positive patients receiving myeloablative chemotherapy and autologous stem cell transplantation.
对于病毒携带者患者，乙型肝炎病毒（HBV）可能是化疗后发生致命性肝衰竭的一个原因，并限制了对他们进行清髓性治疗的指征。我们描述了一名HBsAg阳性的白血病患者，该患者成功接受了自体外周血干细胞移植。化疗治疗后，他的血清HBV DNA水平随肝炎而升高。为防止进展为暴发性肝炎，我们在移植过程中给予了病毒逆转录酶抑制剂拉米夫定。该患者未出现HBV DNA增加或肝炎恶化的情况。因此，拉米夫定对于接受清髓性化疗和自体干细胞移植的HBsAg阳性患者可能是一种有前景的治疗方法。
