Severe hepatitis related to chemotherapy in hepatitis B virus carriers with hematologic malignancies: Survey in Japan, 1987-1991
Article first published online: 6 DEC 1998
Copyright © 1996 American Cancer Society
Volume 78, Issue 10, pages 2210–2215, 15 November 1996
How to Cite
Nakamura, Y., Motokura, T., Fujita, A., Yamashita, T. and Ogata, E. (1996), Severe hepatitis related to chemotherapy in hepatitis B virus carriers with hematologic malignancies: Survey in Japan, 1987-1991. Cancer, 78: 2210–2215. doi: 10.1002/(SICI)1097-0142(19961115)78:10<2210::AID-CNCR24>3.0.CO;2-0
- Issue published online: 6 DEC 1998
- Article first published online: 6 DEC 1998
- Manuscript Revised: 22 JUL 1996
- Manuscript Accepted: 22 JUL 1996
- Manuscript Received: 1 APR 1996
- Ministry of Education, Science, Sports and Culture of Japan
- hepatitis B virus;
- liver failure;
- hematologic diseases;
Hepatitis B (HB) virus (HBV) infection is often reactivated, leading to severe hepatitis and death. Because the actual incidence of such complications is unknown, the authors surveyed hospitals to record the incidence of these complications and to identify clinical parameters that would possibly predict the development of hepatic complications.
First, 250 hospitals, belonging to the Japanese Society of Clinical Hematology, were surveyed for hematologic patients with chronic hepatitis or those with asymptomatic hepatitis virus infection in whom severe hepatitis related to chemotherapy occurred between 1987 and 1991. Second, 117 hospitals that responded to the first questionnaire were surveyed for HBV carriers without severe hepatitis who were prescribed chemotherapy.
One-half the number of patients with severe hepatitis were HBV carriers. The incidence of severe hepatitis (52.7%) and the mortality rate (23.6%) were extremely high in HBV carriers. The incidence of severe hepatitis was significantly higher in patients with chronic hepatitis or those receiving corticosteroids (P < 0.05). The mortality rate was significantly lower in patients who were positive for hepatitis Be antigen (HBeAg) and negative for the antibody to HBeAg (anti-HBe), compared with findings in other patients (P < 0.05).
HBV infection is a major causal agent for severe hepatitis related to chemotherapy in Japanese individuals. Chemotherapy, including corticosteroids, to treat hematologic malignancies should be considered risky in HBV carriers, especially those with chronic hepatitis or serologies negative for HBeAg and positive for anti-HBe. Cancer 1996;78:2210-5.