pci-32765 and Hepatitis-B

Topics: Adenine; Aged; Aged, 80 and over; Female; Follow-Up Studies; Hematologic Neoplasms; Hepatitis B; Hepatitis B virus; Humans; Male; Middle Aged; Piperidines; Pyrazoles; Pyrimidines; Virus Activation

Ibrutinib is a Bruton's tyrosine kinase (BTK) inhibitor approved for the treatment for several mature B-cell malignancies. Reactivation of hepatitis B virus (HBV) is a well-described complication in patients with chronic HBV infection or prior HBV exposure undergoing cytotoxic or immunosuppressive chemotherapy for hematologic malignancies. This phenomenon has been frequently reported with rituximab. However, published data on the risk of HBV reactivation induced by ibrutinib are scarce. Cases of HBV reactivation in hematologic patients receiving ibrutinib therapy have recently been described, but limited only to overt hepatitis B patients or seropositive occult hepatitis B patients.. Our case illustrated that in populations with a high incidence of HBV exposure, systematic screening for HBV exposure is essential prior to ibrutinib treatment, followed by serial monitoring of serologic and molecular markers of hepatitis B. There is a need for an international consensus to support the recommendation of antiviral prophylaxis against HBV reactivation in patients using ibrutinib.

Topics: Aged, 80 and over; Antiviral Agents; DNA, Viral; Female; Hepatitis B; Hepatitis B Antibodies; Hepatitis B Surface Antigens; Hepatitis B virus; Humans; Virus Activation

Topics: Adenine; Aged; Female; Hepatitis B; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Piperidines; Pyrazoles; Pyrimidines; Stents; Superior Vena Cava Syndrome; Tomography, X-Ray Computed; Upper Extremity Deep Vein Thrombosis; Vena Cava, Superior

Topics: Adenine; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Antiviral Agents; Hepatitis B; Hepatitis B virus; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Piperidines; Pyrazoles; Pyrimidines; Treatment Outcome; Virus Activation

Topics: Adenine; Aged; Antiviral Agents; Fatal Outcome; Feasibility Studies; Female; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis B virus; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Male; Middle Aged; Piperidines; Pyrazoles; Pyrimidines; Remission Induction; Virus Activation

Topics: Adenine; Antineoplastic Agents; Antiviral Agents; Biomarkers; Hepatitis B; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Piperidines; Pre-Exposure Prophylaxis; Protein Kinase Inhibitors; Pyrazoles; Pyrimidines; Viral Load

Topics: Adenine; Aged; Hepatitis B; Hepatitis B virus; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Male; Piperidines; Pyrazoles; Pyrimidines; Severity of Illness Index; Virus Activation

Ibrutinib is a small molecule that has been recently developped for the treatment of B cell malignancies. Common side effects are diarrhoea, nausea, fatigue, infections, neutropenia and thrombocytopenia. Here we report the first case of Hepatitis B virus reactivation in a 80 years old chronic lymphocytic leukaemia patient receiving ibrutinib, suggesting that such treatment must be associated with HBV screening.

Topics: Adenine; Aged, 80 and over; Hepatitis B; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Male; Piperidines; Pyrazoles; Pyrimidines; Virus Activation