349P - A retrospective multicenter survey of hepatitis B virus infection (HBV) screening and HBV-DNA monitoring in patients receiving hematopoietic stem c...

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anti-Cancer Agents & Biologic Therapy
Cancer in Special Situations
Haematologic Malignancies
Presenter Toshihisa Nakashima
Citation Annals of Oncology (2016) 27 (suppl_9): ix104-ix111. 10.1093/annonc/mdw586
Authors T. Nakashima1, Y. Ohashi2, S. Oki3, R. Saito4, K. Koido1, C. Ogawa2, N. Sato2, K. Seto3, Y. Negishi4, N. Kondo3, M. Kikuchi5, A. Yokoyama6, H. Ueno6, M. Koinuma7, Y. Yachi2, H. Terakado1
  • 1Pharmacy, National Cancer Center Hospital, 1040045 - Tokyo/JP
  • 2Pharmacy, National Hospital Organization Tokyo Medical Center, Meguro-ku/JP
  • 3Pharmacy, National Center for Global Health and Medicine, 162-8655 - Tokyo/JP
  • 4Pharmacy, National Hospital Organization Shibukawa medical center, 377-8511 - Shibukawa/JP
  • 5Division Of Gastroenterology, National Hospital Organization Tokyo Medical Center, Meguro-ku/JP
  • 6Devision Of Hematology, National Hospital Organization Tokyo Medical Center, Meguro-ku/JP
  • 7Faculty Of Pharmaceutical Sciences, Teikyo Heisei University, 164-8530 - Nakanoku/JP

Abstract

Background

In Japanese clinical practice, the actual conditions for screening and monitoring of HBV reactivation in patients receiving high-risk therapies such as rituximab (R)-based chemotherapy and hematopoietic stem cell transplantation (HSCT) are not well understood.

Methods

At four institutes belonging to national hospital organizations or national centers in Japan, between January 2011 and December 2012, the screening status of HBV infection and frequency of HBV-DNA monitoring were determined in patients with hematological malignancy, who had recently received R-based chemotherapy or HSCT. In patients who exhibited seropositive screening tests, the clinical features of HBV reactivation and hepatitis were analyzed until December 2015 (last follow-up date).

Results

Of the 491 and 265 study patients who received treatment with R-based chemotherapy and HSCT, respectively, 416 (84.7%) and 254 (95.8%) were screened properly prior to treatment. The number of HBV patients receiving the aforementioned respective treatments who exhibited screening test seropositivity was 104 (25.0%) and 46 (18.1%), which comprised 16 (3.8%) and 4 (1.6%) patients with HBsAg positive and 88 (21.2%) and 42 (16.5%) patients with past HBV infection. HBV reactivation occurred in 6 and 4 patients with past HBV infection, respectively. Severe HBV-related hepatitis (alanine aminotransferase >10-fold of the upper limit of normal) occurred in 1 patient receiving HSCT, and there was no hepatitis-related mortality during the study period. The median duration of HBV reactivation from treatment initiation or the day of transplantation was 13.5 months (range: 4–22) and 17 months (range: 3–34), respectively.

Conclusions

In our study, the proportion of screening was higher than that reported previously, but serial HBV-DNA monitoring was not always sufficient. Because late-onset HBV reactivation occurred more often, especially post-HSCT, longer-term monitoring of HBV-DNA is necessary in these populations.

Clinical trial indentification

Legal entity responsible for the study

N/A

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.