Lamivudine投与でB型肝炎の増悪を予防し得た同種骨髄移植後の非Hodgkinリンパ腫  [in Japanese] Prevention of hepatitis B flare-up using lamivudine in a patient with non-Hodgkin's lymphoma after allogeneic bone marrow transplantation  [in Japanese]

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Author(s)

Abstract

症例は22歳,男性。Non-Hodgkin's lymphoma (lymphoblastic lymphoma B-cell type, stageIVA)の診断にて化学療法および放射線療法後に完全寛解となった。HLA検索の結果,母親と完全一致したため,同種骨髄移植目的にて入院となった。患者はHBV感染者であったが,肝機能は正常で本人の希望が強いため移植を施行した。施行後は急性GVHDおよび慢性GVHDを合併したがHBVによる肝機能障害は認めなかった。しかし,経過中にHBV-DNAは徐々に増加してきたため,lamivudine 150 mg連日投与を開始した。その後HBV-DNAは徐々に減少し,肝機能の悪化は認めなかったが,原病の再発にて死亡した。同種骨髄移植後のHBVの増加に対してlamivudineの投与が重篤な肝障害を防ぐ可能性があり,患者がHBV感染者であっても安全に移植後管理ができるものと思われた。

A 22-year-old man with non-Hodgkin's lymphoma (B-cell lymphoblastic lymphoma, Stage IVA) received chemotherapy and radiation therapy and achieved complete remission. He was admitted for allogeneic bone marrow transplantation (BMT) using a graft from his completely HLA-matched mother. Although he had HBV infection, allogeneic BMT was performed because he still had normal liver function and strongly requested the procedure. He developed both acute and chronic GVHD after the procedure, but showed no liver damage related to HBV. Treatment with lamivudine (150 mg/day) was started because the HBV-DNA level increased gradually after allogeneic BMT. Although the HBV-DNA then decreased gradually and there was no evidence of severe liver damage, the patient died following relapse of NHL. It seems that in this case, treatment of HBV with lamivudine may have prevented serious liver damage after allogeneic BMT. Therefore, allogeneic BMT may be done safely in patients with HBV infection if lamivudine is administered.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 41(9), 733-738, 2000-09-30

    The Japanese Society of Hematology

References:  14

Cited by:  1

Codes

  • NII Article ID (NAID)
    10008038233
  • NII NACSIS-CAT ID (NCID)
    AN00252940
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    04851439
  • NDL Article ID
    6295498
  • NDL Source Classification
    ZS21(科学技術--医学--内科学)
  • NDL Call No.
    Z19-295
  • Data Source
    CJP  CJPref  NDL  J-STAGE 
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