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. 2007 Dec;22(4):237-43.
doi: 10.3904/kjim.2007.22.4.237.

Hepatitis B reactivation during adjuvant anthracycline-based chemotherapy in patients with breast cancer: a single institution's experience

Min Kyoung Kim  1 , Jin Hee Ahn, Sung-Bae Kim, Young-Suk Im, Soon Im Lee, Sei-Hyun Ahn, Byung Ho Son, Gyungyub Gong, Hak-Hee Kim, Woo Kun Kim
Affiliations

Hepatitis B reactivation during adjuvant anthracycline-based chemotherapy in patients with breast cancer: a single institution's experience

Min Kyoung Kim et al. Korean J Intern Med. 2007 Dec.

Abstract

Background: The objectives of this study were to determine the incidence, outcome and risk factors for HBV reactivation in HBsAg positive breast cancer patients while on anthracycline -based adjuvant chemotherapy.

Methods: We retrospectively reviewed the records of 2,431 patients with early breast cancer who received adjuvant chemotherapy from March 2001 to December 2005. Among these patients, 111 HBsAg positive women were enrolled in this study.

Results: Thirty-seven patients (33.3%) developed acute hepatitis, of which 23 (20.7%) were related to HBV reactivation. Univariate analysis showed that an age > or = 7 years (p 0 .034) and abnormal sonographic findings such as a fatty liver or cirrhotic changes (p= 0 .034) were associated with HBV reactivation. However, an HBeAg positive status and the use of corticosteroids were not. Multivariate analysis found that no clinical factors could predict HBV reactivation during chemotherapy. All 23 patients who developed HBV reactivation received lamivudine as a therapeutic measure at the time of HBV reactivation. Despite the use of lamivudine, disruption in the chemotherapy protocol occurred in 18 patients (78.3%) and 14 of these patients had premature termination of their chemotherapy.

Conclusions: HBV reactivation occurred in a significant proportion of HBsAg positive patients during adjuvant anthracycline-based chemotherapy. Once hepatitis developed, most patients could not finish the chemotherapy as planned despite lamivudine treatment. Until the risk factors for reactivation are clearly identified, HbsAg-positive patients should begin prophylactic antiviral treatment before initiating chemotherapy.

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Figures

Figure 1
Figure 1
Summary of enrollment of patients.
See this image and copyright information in PMC

References

    1. Lee DH, Kim JH, Nam JJ, Kim HR, Shin HR. Epidemiological findings of hepatitis B infection based on 1998 National Health and Nutrition Survey in Korea. J Korean Med Sci. 2002;17:457–462. - PMC - PubMed
    1. Galbraith RM, Eddleston AL, Williams R, Zuckerman AJ. Fulminant hepatic failure in leukaemia and choriocarcinoma related to withdrawal of cytotoxic drug therapy. Lancet. 1975;2:528–530. - PubMed
    1. Lok AS, Liang RH, Chiu EK, Wong KL, Chan TK, Todd D. Reactivation of hepatitis B virus replication in patients receiving cytotoxic therapy. Gastroenterology. 1991;100:182–188. - PubMed
    1. Kumagai K, Takagi T, Nakamura S, Sawada U, Kura Y, Kodama F, Shimano S, Kudoh I, Nakamura H, Sawada K, Ohnoshi T. Hepatitis B virus carriers in the treatment of malignant lymphoma: an epidemiological study in Japan. Ann Oncol. 1997;8(Suppl 1):107–109. - PubMed
    1. Nakamura Y, Motokura T, Fujita A, Yamashita T, Ogata E. Severe hepatitis related to chemotherapy in hepatitis B virus carriers with hematologic malignancies: survey in Japan, 1987-1991. Cancer. 1996;78:2210–2215. - PubMed

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