Tanaka Hiroaki, Sakuma Ikuo, Hashimoto Shinichiro, Takeda Yusuke, Sakai Shio, Takagi Toshiyuki, Shimura Takanori, Nakaseko Chiaki
Department of Hematology, Oami Hospital, Chiba, Japan.
J Clin Exp Hematop. 2012;52(1):67-9. doi: 10.3960/jslrt.52.67.
It has recently been reported that hepatitis B virus (HBV) reactivation in patients with hepatitis B surface antigen (HBsAg)-negative lymphoma during or after cytotoxic therapy occurs after the use of rituximab and stem cell transplantation for hematologic malignancies. However, clinical data on HBV reactivation in multiple myeloma patients have not been extensively reported. This is the first reported case of HBV reactivation in an HBsAg-negative myeloma patient treated with bortezomib (BOR) as salvage therapy and not stem cell transplantation. By closely monitoring HBV-DNA and early administration of entecavir, severe hepatitis was avoided and BOR therapy was continued. We suggest the importance of close monitoring of HBV-DNA for transplant-ineligible myeloma patients treated with BOR as salvage therapy.
最近有报道称，在细胞毒性治疗期间或之后，乙肝表面抗原（HBsAg）阴性的淋巴瘤患者中，在使用利妥昔单抗和进行造血系统恶性肿瘤干细胞移植后会发生乙型肝炎病毒（HBV）再激活。然而，关于多发性骨髓瘤患者HBV再激活的临床数据尚未得到广泛报道。这是首例报告的使用硼替佐米（BOR）作为挽救治疗而非干细胞移植的HBsAg阴性骨髓瘤患者发生HBV再激活的病例。通过密切监测HBV-DNA并早期给予恩替卡韦，避免了严重肝炎的发生，并继续进行BOR治疗。我们建议，对于接受BOR作为挽救治疗的不适合移植的骨髓瘤患者，密切监测HBV-DNA非常重要。
