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Infections Post Transplant

A possible role for lamivudine as prophylaxis against hepatitis B reactivation in carriers of hepatitis B who undergo chemotherapy and autologous peripheral blood stem cell transplantation for non-Hodgkin's lymphoma

Bone Marrow Transplantation volume 27, pages 433–436 (2001)Cite this article

Abstract

Hepatitis B virus (HBV) reactivation, a well-known complication in immunosuppressed patients, can give rise to acute hepatitis and even fatal fulminant hepatitis. Three Japanese males with non-Hodgkin's lymphoma (NHL) who were carriers of HBV received high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (PBSCT). To prevent HBV reactivation, all received oral lamivudine (150 mg/day), a nucleoside analogue, at the start of chemotherapy. All were treated at full-dose intensity, including corticosteroids, without modification of treatment regimens. All three patients completed the total course of chemotherapy and PBSCT, with no signs of HBV reactivation. Peripheral blood stem cell (PBSC) harvests and hematological recoveries after transplantation were not affected by lamivudine, which was continued for at least 16 weeks after transplantation. HBV-DNA and DNA polymerase levels remained negative/normal after discontinuation of lamivudine. Lamivudine effectively inhibits HBV replication and has few serious adverse effects, particularly those related to hematopoiesis. Thus, prophylactic use of lamivudine from initiation of chemotherapy deserves consideration in the treatment of HBV carriers who require immunosuppressive chemotherapy, and may prevent HBV reactivation. Bone Marrow Transplantation (2001) 27, 433–436.

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Acknowledgements

We thank S Okazaki for manuscript preparation. Supported in part by Grants-in-Aid (12670970) from the Ministry of Education, Science, Sports and Culture of Japan, a research grant from the Idiopathic Disorders of Hematopoietic Organs Research Committee of the Ministry of Health and Welfare, Japan and Health Science Research Grant for Research on Human Genome and Gene Therapy (H10-genome-007) from the Ministry of Health and Welfare.

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  1. Department of Internal Medicine II, Hokkaido University School of Medicine, Sapporo, Japan

    T Endo, T Sakai, K Fujimoto, S Yamamoto, H Takashima, Y Haseyama, M Nishio, K Koizumi, T Koike & K Sawada

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  1. T Endo
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  2. T Sakai
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  3. K Fujimoto
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Endo, T., Sakai, T., Fujimoto, K. et al. A possible role for lamivudine as prophylaxis against hepatitis B reactivation in carriers of hepatitis B who undergo chemotherapy and autologous peripheral blood stem cell transplantation for non-Hodgkin's lymphoma. Bone Marrow Transplant 27, 433–436 (2001). https://doi.org/10.1038/sj.bmt.1702804

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