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Treatment of HBV-carrying lymphoma patients with Rituximab and CHOP: a diagnostic and therapeutic challenge

Leukemia volume 16, pages 1884–1886 (2002)Cite this article

Reactivation of hepatitis B virus (HBV) infection in HBs-Ag-positive patients is a well documented complication of cytotoxic or immunosuppressive therapy. The incidence of hepatitis directly attributed to reactivation of HBV has been reported as 49% in HBs-Ag-positive patients with lymphoma.1

Follicular lymphoma in advanced stages continues to be a therapeutic challenge with respect to curability. Encouraging results regarding clinical and molecular remission of follicular lymphoma are seen in patients who received combination therapy (R-CHOP) consisting of CHOP (cyclophosphamid, doxorubicin, vincristin, prednisone) and rituximab, the monoclonal CD20 antibody. A less effective therapy may jeopardize a patient's chance for remission, of which, molecular remission seems to be a prerequisite for long disease-free intervals. There are few reports2,3,4 about reactivation of HBV during the treatment of hematological malignancies with rituximab in addition to concomitant or previous chemo- or immunsuppressive therapy (CHOP, fludarabine, prednisone). Confounding factors were present in each case (Table 1) leaving an unclear relationship between HBV reactivation and the monoclonal CD20 antibody. In order to elucidate this situation we report our experiences in an HBV-carrying patient who developed severe hepatitis after R-CHOP.

Table 1 Reports on reactivation of hepatitis B virus infection during the treatment of hematological malignancies with cytotoxic and/or immunosuppressive therapy plus rituximab
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Authors and Affiliations

  1. Division of Hematology, University of Vienna, General Hospital of Vienna, Vienna, Austria

    C Skrabs, H Agis & U Jäger

  2. Division of Gastroenterology, University of Vienna, General Hospital of Vienna, Vienna, Austria

    C Müller

  3. Division of Molecular Biology, University of Vienna, General Hospital of Vienna, Vienna, Austria

    C Mannhalter

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  1. C Skrabs
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  2. C Müller
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  3. H Agis
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Skrabs, C., Müller, C., Agis, H. et al. Treatment of HBV-carrying lymphoma patients with Rituximab and CHOP: a diagnostic and therapeutic challenge. Leukemia 16, 1884–1886 (2002). https://doi.org/10.1038/sj.leu.2402567

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