按需使用 glecaprevir 和 pibrentasvir 成功治疗弥漫性大 B 细胞淋巴瘤患者 R-CHOP 期间丙型肝炎 flares：一例报告。
Successful treatment by on-demand glecaprevir and pibrentasvir for hepatitis C flare during R-CHOP in patients with diffuse large B-cell lymphoma: a case report.
机构信息
Sapporo Hokuyu Hospital, Sapporo, Hokkaido, Japan.
Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
出版信息
BMC Infect Dis. 2021 Apr 27;21(1):389. doi: 10.1186/s12879-021-06091-x.
BACKGROUND
In patients with hepatitis C virus (HCV) and malignant lymphoma, hepatitis C flare during R-CHOP can result in discontinuation of treatment. However, appropriate therapeutic strategies for managing hepatitis C flare during R-CHOP have not been established, and this issue is complicated by conflicting results regarding the use of direct-acting antivirals in patients with uncontrolled malignancies.
CASE PRESENTATION
We report the first case of effective and safe treatment with on-demand 8-week glecaprevir and pibrentasvir for hepatitis C flare during R-CHOP in a patient with diffuse large B-cell lymphoma (DLBCL). The patient completed five additional courses of R-CHOP without hepatic toxicity. A complete response of DLBCL and a sustained virological response were observed at 24 weeks after glecaprevir and pibrentasvir completion.
CONCLUSION
On-demand, direct-acting antivirals could be a novel strategy for managing hepatitis C flare during R-CHOP.
背景
在丙型肝炎病毒（HCV）合并恶性淋巴瘤患者中，R-CHOP 期间的丙型肝炎发作可导致治疗中断。然而，对于 R-CHOP 期间丙型肝炎发作的管理，尚未确立适当的治疗策略，而对于未控制的恶性肿瘤患者使用直接作用抗病毒药物的结果存在矛盾，这使得该问题更加复杂。
病例介绍
我们报告了首例在弥漫性大 B 细胞淋巴瘤（DLBCL）患者中，在 R-CHOP 期间丙型肝炎发作时采用按需治疗 8 周的格卡瑞韦哌仑他韦治疗有效且安全的病例。患者在无肝毒性的情况下完成了另外五个周期的 R-CHOP。在完成格卡瑞韦哌仑他韦治疗 24 周后，观察到 DLBCL 完全缓解和持续病毒学应答。
结论
按需使用直接作用抗病毒药物可能是 R-CHOP 期间管理丙型肝炎发作的一种新策略。
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