Tsukune Yutaka, Sasaki Makoto, Komatsu Norio
Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421, Japan.
Cancers (Basel). 2019 Nov 19;11(11):1819. doi: 10.3390/cancers11111819.
Reactivation of hepatitis B virus (HBV) is a well-known complication in patients with hematological malignancies during or after cytotoxic chemotherapy. If the initiation of antiviral therapy is delayed in patients with HBV reactivation, these patients can develop severe hepatitis and may die of fulminant hepatitis. The preventive strategy for HBV reactivation in patients with malignant lymphoma has already been established based on some prospective studies. As there was an increased number of novel agents being approved for the treatment of multiple myeloma (MM), the number of reported cases of HBV reactivation among MM patients has gradually increased. We conducted a Japanese nationwide retrospective study and revealed that HBV reactivation in MM patients is not rare and that autologous stem cell transplantation is a significant risk factor. In this study, around 20% of all patients with HBV reactivation developed HBV reactivation after 2 years from the initiation of therapy, unlike malignant lymphoma. This might be due to the fact that almost all of the patients received chemotherapy for a long duration. Therefore, a new strategy for the prevention of HBV reactivation in MM patients is required.
乙型肝炎病毒（HBV）再激活是血液系统恶性肿瘤患者在细胞毒性化疗期间或之后的一种众所周知的并发症。如果HBV再激活患者的抗病毒治疗开始延迟，这些患者可能会发展为严重肝炎，并可能死于暴发性肝炎。基于一些前瞻性研究，已经确立了恶性淋巴瘤患者HBV再激活的预防策略。由于有越来越多的新型药物被批准用于治疗多发性骨髓瘤（MM），MM患者中报告的HBV再激活病例数量逐渐增加。我们进行了一项日本全国性回顾性研究，发现MM患者中的HBV再激活并不罕见，自体干细胞移植是一个重要的危险因素。在本研究中，与恶性淋巴瘤不同，所有HBV再激活患者中约20%在治疗开始2年后发生HBV再激活。这可能是由于几乎所有患者都接受了长时间的化疗。因此，需要一种预防MM患者HBV再激活的新策略。
