Duan Ming-Hui, Cao Xin-Xin, Chang Long, Zhou Dao-Bin
Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Hematology. 2021 Dec;26(1):460-464. doi: 10.1080/16078454.2021.1945234.
Objectives The aim of this retrospective analysis was to assess the incidence of hepatitis B virus (HBV) reactivation among patients with myeloproliferative neoplasms (MPN) during and after ruxolitinib treatment. Methods Between February 2013 and February 2020, 224 patients with MPN were treated using ruxolitinib at Peking Union Medical College Hospital. Of these, 6 had chronic, and 56 had resolved HBV infection, including 43 patients who received combination treatment with thalidomide, prednisone, and stanozolol (TSP) during ruxolitinib treatment. Results Two patients with chronic HBV infection who did not take any antiviral prophylaxis developed HBV reactivation and hepatitis flare. The other four patients with chronic HBV infection, who took antiviral prophylaxis before ruxolitinib treatment, did not develop HBV reactivation. Also, no patients with resolved HBV infection received antiviral prophylaxis and developed HBV reactivation. Conclusion This study demonstrated that HBV reactivation and hepatitis flare might commonly occur a few months after initiating ruxolitinib treatment in patients with chronic HBV infection who did not take antiviral prophylaxis, especially in combination with TSP. Still, it was extremely rare in patients with resolved HBV infection.
目的 本回顾性分析旨在评估鲁索替尼治疗期间及治疗后骨髓增殖性肿瘤（MPN）患者中乙型肝炎病毒（HBV）再激活的发生率。方法 2013年2月至2020年2月期间，北京协和医院使用鲁索替尼治疗了224例MPN患者。其中，6例为慢性HBV感染，56例既往有HBV感染已康复，包括43例在鲁索替尼治疗期间接受沙利度胺、泼尼松和司坦唑醇（TSP）联合治疗的患者。结果 2例未采取任何抗病毒预防措施的慢性HBV感染患者发生了HBV再激活和肝炎发作。另外4例在鲁索替尼治疗前采取了抗病毒预防措施的慢性HBV感染患者未发生HBV再激活。此外，既往有HBV感染已康复的患者中，没有患者接受抗病毒预防且发生HBV再激活。结论 本研究表明，在未采取抗病毒预防措施的慢性HBV感染患者中，尤其是联合TSP治疗时，开始使用鲁索替尼治疗数月后可能常见HBV再激活和肝炎发作。不过，在既往有HBV感染已康复的患者中极为罕见。
