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Poster Display session 1

4852 - Impact of routine screening and preemptive treatment on hepatitis B virus reactivation (HBVr) in patients receiving chemotherapy


28 Sep 2019


Poster Display session 1


Supportive Care and Symptom Management

Tumour Site


Celine Marty


Annals of Oncology (2019) 30 (suppl_5): v718-v746. 10.1093/annonc/mdz265


C. Marty1, D. Martel2, V. Martel-Laferrière3, S. Doucet4, P. Céballos5, J. Adam2

Author affiliations

  • 1 Faculty Of Pharmacy, Aix-Marseille Université, 13385 - Marseille/FR
  • 2 Pharmacy, Centre hospitalier de l’Université de Montréal (CHUM), H2X 0C1 - Montreal/CA
  • 3 Microbiology And Infectious Diseases, Centre hospitalier de l’Université de Montréal (CHUM), H2X0C1 - Montreal/CA
  • 4 Medical Oncology/hematology, Centre hospitalier de l’Université de Montréal (CHUM), H2X0C1 - Montreal/CA
  • 5 Clinical Hematology, Centre Hospitalier Universitaire Saint-Eloi, 34090 - Montpellier/FR


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Abstract 4852


Guidelines diverge about the need for systematic HBV screening for all patients starting chemotherapy. At the Centre hospitalier de l’Université de Montréal (CHUM), systematic HBV screening is requested on pre-printed chemotherapy order (PPCO) at high risk of HBVr with follow-up by a pharmacist. For all other PPCO, doctors can request HBV screening and follow-up. A decision algorithm is available for all clinicians. The aim of this study is to assess whether patients undergoing routine HBV screening could reduce the incidence of HBVr.


This is a retrospective observational study including patients who received an IV chemotherapy for cancer between July 2017 and June 2018 at the CHUM. We compared the incidence and complications of HBVr in patients with HBV screening as requested on PPCO (group 1) or on demand from the medical team (group 2) to patients who were not screened (group 3).


On a total of 1374 patients, 179 of 206 (13%) patients were screened as requested on PPCO (group 1) and 421 (30%) by the medical team (group 2). Patient characteristics, duration of treatment and follow-up for all groups are listed in the table. No difference was seen on the incidence of HBVr between screened and unscreened patients (0% vs 0.1%; p = 0.36) probably because of a lack of follow-up after chemotherapy. Optimal follow-up for HBVr based on the decisional algorithm appears to be better in group 1 than group 2 (50% vs 25%; p = 0.13). For patients on anti-CD20 therapy in group 1, HBV screening was done for 92% of patients which is a higher rate compare to previously reported data. In group 3, 89 patients had ALT elevation (>100U/L and x3 baseline value) during chemotherapy but only 17 patients (19%) were tested for the possibility of HBVr.Table:


Group 1 n = 206 (%)Group 2 n = 421 (%)Group 3 n = 747 (%)
Screening before chemotherapy179 (86.9)421 (100)0 (0)
Nb of pts who had finished chemotherapy treatment at the time of analysis174 (84.5)402 (95.5)699 (93.6)
Median duration (months) of chemotherapy (IQR)10.5 (6.4-14.4)4 (1.4-9.1)3.6 (1.6-5.6)
HBsAg + Anti-HBc + HBV-DNA +0 (0) 17 (8.3) 1 (0.5)2 (0.5) 36 (8.6) 2 (0.5)-
Incomplete screening5 (2.8)31 (7.4)-
Antiviral prophylaxis required Antiviral prophylaxis initiated8 (3.9) 7 (3.4)3 (0.7) 3 (0.7)-
Follow-up required Follow-up Optimal follow-up18 (8.7) 10 (4.9) 9 (4.4)36 (8.6) 13 (3.1) 9 (2.1)-
Number of patients who had a follow-up after chemotherapy3 (1.5)5 (1.2)
HBV reactivation0 (0)0 (0)1 (0.1)


Systematic HBV detection requested on PPCO is an effective way to increase HBV screening and prevent HBVr in patients receiving chemotherapy. However, this method does not guarantee optimal follow-up and requires improvements.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.


Has not received any funding.


D. Martel: Honoraria (self): Abbvie Canada; Honoraria (self): Gilead Sciences Canada; Honoraria (self): Merck Canada. V. Martel-Laferrière: Research grant / Funding (self), Clinical Research Scholars - Junior 1: Fonds de la recherche en santé du Québec. S. Doucet: Honoraria (self), Advisory / Consultancy: AbbVie Canada; Honoraria (self), Advisory / Consultancy: Gilead Sciences Canada; Honoraria (self): Merck Canada; Advisory / Consultancy: Roche; Advisory / Consultancy: BMS; Honoraria (self), Advisory / Consultancy: Janssen; Honoraria (self): Seattle Genetics. J. Adam: Honoraria (self): Amgen Canada; Advisory / Consultancy: Celgene; Honoraria (self), Advisory / Consultancy: Novartis; Advisory / Consultancy: Janssen; Honoraria (self), Advisory / Consultancy: AbbVie; Advisory / Consultancy: Lundbeck. All other authors have declared no conflicts of interest.

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