Acute hepatic injury after the withdrawal of immunosuppressive chemotherapy in patients with hepatitis B

Cancer. 1990 Feb 15;65(4):878-84. doi: 10.1002/1097-0142(19900215)65:4<878::aid-cncr2820650409>3.0.co;2-k.

Abstract

Five patients with lymphoproliferative malignancies and chronic hepatitis B suffered severe acute hepatic injury after the withdrawal of multiagent chemotherapy that included high-dose corticosteroid. Four patients died of hepatic failure, three of whom received corticosteroid as treatment for the hepatic injury. We believe that the cause of this entity is massive immune-associated cytolysis of hepatitis B virus infected hepatocytes occurring after a period of immunosuppression and increased viral replication. The literature regarding this complication of chemotherapy and its pathophysiology is reviewed.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chronic Disease
  • Female
  • Hepatitis B / complications*
  • Hepatitis B / enzymology
  • Hepatitis B / immunology
  • Hepatitis B Surface Antigens / analysis
  • Hodgkin Disease / complications
  • Hodgkin Disease / drug therapy*
  • Hodgkin Disease / enzymology
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / complications
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*
  • Leukemia, Lymphocytic, Chronic, B-Cell / enzymology
  • Liver / drug effects*
  • Liver Function Tests
  • Lymphoma / complications
  • Lymphoma / drug therapy*
  • Lymphoma / enzymology
  • Lymphoma, Non-Hodgkin / complications
  • Lymphoma, Non-Hodgkin / drug therapy*
  • Lymphoma, Non-Hodgkin / enzymology
  • Male
  • Middle Aged
  • Prednisone / administration & dosage
  • Prednisone / therapeutic use

Substances

  • Hepatitis B Surface Antigens
  • Prednisone