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Incidence and clinical background of hepatitis B virus reactivation in multiple myeloma in novel agents’ era

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Abstract

There are some reports regarding hepatitis B virus (HBV) reactivation in patients with myeloma who are HBV carriers or who have had a resolved HBV infection, and there is no standard prophylaxis strategy for these patients. We performed a retrospective multicenter study to determine the incidence and characteristics of HBV reactivation in patients with multiple myeloma. We identified 641 patients with multiple myeloma who had been treated using novel agents and/or autologous stem cell transplantation with high-dose chemotherapy between January 2006 and June 2014 at nine Japanese hospitals. The patients’ characteristics, laboratory data, and clinical courses were retrieved and statistically analyzed. During a median follow-up of 101 weeks, one of eight (12.5 %) HBV carriers developed hepatitis and 9 of 99 (9.1 %) patients with resolved HBV infection experienced HBV reactivation; the cumulative incidences of HBV reactivation at 2 years (104 weeks) and 5 years (260 weeks) were 8 and 14 %, respectively. The nine cases of reactivation after resolved HBV infection had received entecavir as preemptive therapy or were carefully observed by monitoring their HBV DNA levels, and none of these cases developed hepatitis. Among patients with multiple myeloma, HBV reactivation was not rare. Therefore, long-term monitoring of HBV DNA levels is needed to prevent hepatitis that is related to HBV reactivation in these patients.

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Authors and Affiliations

  1. Department of Hematology, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Yutaka Tsukune, Makoto Sasaki, Yuriko Yahata & Norio Komatsu

  2. Faculty of Health Science, Daito Bunka University School of Sports and Health Science, Saitama, Japan

    Takeshi Odajima

  3. Department of Hematology, National Hospital Organization Nishigunma Hospital, Gunma, Japan

    Atsushi Isoda & Morio Matsumoto

  4. Department of Hematology, Juntendo University Shizuoka Hospital, Shizuoka, Japan

    Michiaki Koike

  5. Division of Hematology, Department of Medicine, Nippon Medical School, Tokyo, Japan

    Hideto Tamura & Keiichi Moriya

  6. Department of Medical Oncology, Iwate Medical University School of Medicine, Iwate, Japan

    Shigeki Ito

  7. Hematology and Oncology, Department of Internal Medicine, Iwate Medical University School of Medicine, Iwate, Japan

    Maki Asahi

  8. Department of Hematology, Tokyo Women’s Medical University, Tokyo, Japan

    Yoichi Imai & Junji Tanaka

  9. Department of Medicine and Clinical Science, Gunma University, Gunma, Japan

    Hiroshi Handa

  10. Infection Control and Prevention Center, Gunma University Hospital, Gunma, Japan

    Hiromi Koiso

  11. Department of Hematology, The Fraternity Memorial Hospital, Tokyo, Japan

    Sakae Tanosaki

  12. Department of Hematology, Eiju General Hospital, Tokyo, Japan

    Jian Hua & Masao Hagihara

  13. Department of Gastroenterology, Tokyo Metropolitan Health and Medical Treatment Corporation Tobu Chiiki Hospital, Tokyo, Japan

    Satoko Suzuki

  14. Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan

    Sumio Watanabe

  15. Department of Preventive Medicine, Daito Bunka University Graduate School of Sports and Health Science, Saitama, Japan

    Hiroki Sugimori

Authors
  1. Yutaka Tsukune
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  2. Makoto Sasaki
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  3. Takeshi Odajima
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  4. Atsushi Isoda
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  5. Morio Matsumoto
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  6. Michiaki Koike
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  7. Hideto Tamura
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  8. Keiichi Moriya
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  9. Shigeki Ito
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  10. Maki Asahi
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  11. Yoichi Imai
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  12. Junji Tanaka
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  13. Hiroshi Handa
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  14. Hiromi Koiso
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  15. Sakae Tanosaki
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  16. Jian Hua
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  17. Masao Hagihara
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  18. Yuriko Yahata
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  19. Satoko Suzuki
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  20. Sumio Watanabe
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  21. Hiroki Sugimori
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  22. Norio Komatsu
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Corresponding author

Correspondence to Makoto Sasaki.

Ethics declarations

This study was performed in accordance with the ethical principles of the Declaration of Helsinki and was approved by the ethics review board at each participating institution.

Conflict of interest

SW received scholarship donations from Bristol-Myers Squibb Company and MSD K.K. The other authors have no conflicts of interest to declare.

Authorship statement

YT and MS contributed equally to this work. YT, MS, SS, SW, and NK designed the study. AI, MM, MK, HT, KM, SI, MA, YI, JT, HH, HK, ST, JH, MH, and YY collected the clinical data. TO and HS performed the statistical analysis. The manuscript was written by YT, MS, and NK.

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Tsukune, Y., Sasaki, M., Odajima, T. et al. Incidence and clinical background of hepatitis B virus reactivation in multiple myeloma in novel agents’ era. Ann Hematol 95, 1465–1472 (2016). https://doi.org/10.1007/s00277-016-2742-7

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