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Acute leukaemia in chronic hepatitis B patients with lamivudine therapy

Authors

  • R-N. Chien,

    Corresponding author
    1. Liver Research Unit,1Department of Hematology,2Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
      †Prof Rong-Nan Chien, Liver Research Unit, Chang Gung Memorial Hospital, 222, Mai-Chin Road, Keelung, Taiwan
      Tel.: 886-2-24313131x2601
      Fax: 886-2-24335342
      Email: ronald@adm.cgmh.org.tw
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    • *

      Current address: Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital, Keelung, 222 Mai-Chin Road, Keelung, Taiwan.

  • 1 C-T. Yeh,

    1. Liver Research Unit,1Department of Hematology,2Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
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  • 1 P-N. Wang,

    1. Liver Research Unit,1Department of Hematology,2Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
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  • 2 M-C. Kuo,

    1. Liver Research Unit,1Department of Hematology,2Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
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  • 2 S-Y. Hsieh,

    1. Liver Research Unit,1Department of Hematology,2Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
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  • 1 L-Y. Shih,

    1. Liver Research Unit,1Department of Hematology,2Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
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  • and 2 Y-F. Liaw 1

    1. Liver Research Unit,1Department of Hematology,2Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
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†Prof Rong-Nan Chien, Liver Research Unit, Chang Gung Memorial Hospital, 222, Mai-Chin Road, Keelung, Taiwan
Tel.: 886-2-24313131x2601
Fax: 886-2-24335342
Email: ronald@adm.cgmh.org.tw

Summary

Extensive clinical data have shown that lamivudine is an effective and safe drug for patients with chronic hepatitis B virus infection. No significant serious side effect has been reported.

Four hundred and forty-eight patients with chronic hepatitis B, treated with lamivudine for more than 6 months, were closely monitored.

Two patients developed acute myeloid leukaemia during or after lamivudine therapy. The first case developed acute myeloid leukaemia, 1 year after stopping lamivudine therapy, when A529T mutant HBV-DNA was still detectable. The second case achieved complete virological response but suffered from acute myeloid leukaemia during the ninth month of lamivudine treatment. D553N mutant hepatitis B virus was detected in granulocytes of her peripheral blood.

Based on our lamivudine therapy data, the calculated incidence of acute myeloid leukaemia in patients during or after lamivudine therapy was higher in males and females than that of the general population. Whether lamivudine-selected viral mutations have enhanced activity/production of transcriptional transactivator and thereby increased the chance of leukaemic transformation of haematopoietic progenitor cells deserves further investigation.

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