Reactivation of resolved infection with the hepatitis B virus immune escape mutant G145R during dasatinib treatment for chronic myeloid leukemia
Reactivation of resolved infection with the hepatitis B virus immune escape mutant G145R during dasatinib treatment for chronic myeloid leukemia
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DOI：
10.1007/s12185-015-1788-y
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发表时间：
2015-09-01
影响因子：
2.1
通讯作者：
Kimura, Shinya
中科院分区：
文献类型：
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作者：
Ando, Toshihiko;Kojima, Kensuke;Kimura, Shinya
免疫抑制治疗或造血干细胞移植后B型肝炎病毒（HBV）的再激活是一种潜在的致命并发症，即使在既往HBV感染消退的患者中也可能发生。达沙替尼是一种酪氨酸激酶SRC和ABL的小分子抑制剂，已被批准用于治疗慢性粒细胞白血病（CML）和费城染色体阳性急性淋巴细胞白血病。在这里，我们报告了第一例在接受达沙替尼治疗的CML患者中，HBV免疫逃逸突变体G145R感染复发的病例。虽然达沙替尼不被认为是一种免疫抑制剂，但我们的观察结果表明，达沙替尼可能会增强HBV复制并诱导免疫功能正常的患者再激活，HBV逃逸突变体可能有助于HBV再激活的发病机制，建议在当前或已消退的HBV感染患者中密切监测HBV状态。
Reactivation of hepatitis B virus (HBV) following immunosuppressive therapy or hematopoietic stem cell transplantation is a potentially fatal complication that may occur even in patients with prior resolution of HBV infection. Dasatinib is a small-molecule inhibitor of the tyrosine kinases SRC and ABL that has been approved for the treatment of chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia. Here, we report the first case of reactivation of resolved infection with the HBV immune escape mutant G145R in a CML patient receiving dasatinib. Although dasatinib is not recognized as an immunosuppressant, our observations suggest that dasatinib may enhance HBV replication and induce its reactivation in immunocompetent patients, that HBV escape mutants may contribute to the pathogenesis of HBV reactivation, and that close monitoring of HBV status is advisable in patients with current or resolved HBV infection.