Preventing chemotherapy-induced hepatitis B reactivation in breast cancer patients: A prospective comparison of prophylactic versus deferred preemptive lamivudine

Shih Hung Tsai, Ming Shen Dai, Jyh Cherng Yu, Ching Liang Ho, Yeu Chin Chen, Yi Ying Wu, Ping Ying Chang, Woei Yau Kao, Tsu Yi Chao

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8 引文 斯高帕斯(Scopus)

摘要

Purpose Prophylactic lamivudine to prevent chemotherapyinduced hepatitis B virus (HBV) reactivation has been widely adopted in hematological cancer patients. We examined the deferred preemptive strategy, upon rising viremia, in breast cancer (BC) patients based on sensitive serum HBV DNA level monitoring in a non-randomized controlled study. Patients and methods Baseline virological profiles before cytotoxic chemotherapy were retrospectively analyzed in historical BC and non-BC patients. A prospective cohort study, including 22 early BC patients (Group I) who were hepatitis B surface antigen (HBsAg)± and required adjuvant chemotherapy, were enrolled and had deferred preemptive use of lamivudine upon viremic surge. During the study period, another 23 BC patients, who did not participate in the abovementioned study, received prophylactic use of lamivudine as routine practice (Group 2). Chemotherapyinduced hepatitis events and the lamivudine treatment course were compared. Results There was no significant difference in the incidence of hepatitis during chemotherapy between these two groups. Patients in Group I had statistically significant shorter duration of lamivudine use during chemotherapy. However, once lamivudine had been initiated, the treatment course is not significantly shorter than those patients given prophylactically. Conclusions Deferred preemptive strategy is feasible to control HBV replication and prevent its reactivation in BC patients undergoing chemotherapy. However, it may not be superior to prophylactic strategy and clinically practical.
原文英語
頁(從 - 到)1779-1787
頁數9
期刊Supportive Care in Cancer
19
發行號11
DOIs
出版狀態已發佈 - 11月 2011

ASJC Scopus subject areas

  • 腫瘤科

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