J Korean Med Sci.  2003 Dec;18(6):849-854. 10.3346/jkms.2003.18.6.849.

The Prophylactic Use of Lamivudine Can Maintain Dose-Intensity of Adriamycin in Hepatitis-B Surface Antigen (HBs Ag)-positive Patients with Non-Hodgkin's Lymphoma Who Receive Cytotoxic Chemotherapy

• Lee GW
• Ryu MH
• Lee JL
• Oh S
• Kim E
• Lee JH
• Kim SB
• Kim SW
• Suh C
• Lee KH
• Kim WK
• Lee JS
• Kang YK

• KMID: 1086742
• DOI: http://doi.org/10.3346/jkms.2003.18.6.849

Abstract

We investigated the effectiveness of lamivudine to prevent hepatitis flare up due to reactivation of hepatitis-B virus (HBV) in hepatitis-B surface antigen (HBsAg)-positive patients with Non-Hodgkin's lymphoma (NHL) during cytotoxic chemotherapy. HBsAg-positive patients with NHL were identified from the lymphoma database of the Asan Medical Center from January 1995 to August 2002, and their medical records were reviewed. We found that 31 patients were received cytotoxic chemotherapy among 41 NHL patients with HBsAg-positive during same period. We divided them into 2 groups of HBsAg patients with NHL as follows: Group A who received cytotoxic chemotherapy with lamivudine 100 mg daily; Group B without any prophylactic antiviral therapy. There were no significant differences between Group A and B in several clinical variables. Seventeen patients (85%) in group B and one patient (9%) in Group A had hepatitis due to reactivation of HBV (p<0.001), with one hepatic failure related death in Group B and none in group A. The mean dose intensity of adriamycin actually delivered was 13.3 mg/m2/week (80% Relative Dose intensity (RDI)) in Group A and 9.1 mg/m2/week (55% RDI) in Groups B (p<0.001). Our data suggest that the frequency of chemotherapy-related HBV reactivation may be significantly decreased by lamivudine prophylaxis with maintenance of the dosage of adriamycin.

Keyword

Lymphoma; Non-Hodgkin; Hepatitis B; Lamivudine; Antineoplastic combined Chemotherapy Protocols; Chemoprevention

MeSH Terms

Adult
Aged
Antibiotics, Antineoplastic/*therapeutic use
Doxorubicin/*therapeutic use
Female
Hepatitis B/complications/diagnosis/*drug therapy
Hepatitis B Surface Antigens/*analysis
Hepatitis B Virus/metabolism
Human
Lamivudine/*therapeutic use
Lymphoma, Non-Hodgkin/complications/*drug therapy/metabolism
Male
Middle Aged
Reverse Transcriptase Inhibitors/*therapeutic use
Survival Rate
Virus Activation