Serial studies of hepatitis-associated antigen and antibody in patients receiving antitumor chemotherapy for myeloproliferative and lymphoproliferative disorders.
Serial studies of hepatitis-associated antigen and antibody in patients receiving antitumor chemotherapy for myeloproliferative and lymphoproliferative disorders.
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DOI：
10.1016/s0016-5085(75)80054-0
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发表时间：
1975
期刊：
影响因子：
29.4
通讯作者：
J. Wands;C. Chura;F. Roll;W. Maddrey
中科院分区：
文献类型：
--
作者：
J. Wands;C. Chura;F. Roll;W. Maddrey
对25例骨髓增生性疾病患者和60例淋巴增生性疾病患者进行了抗肿瘤化疗药物对乙肝病毒抗原(HBAg)和抗体(HBAb)的动态观察。17例患者检测到HBAg，40例检测到HBAb。17名在治疗前立即检测到HBAb的患者HBAb滴度下降，这与白细胞计数的下降相平行。在这些患者中，有5例在HBAb滴度下降时出现HBAg。在5例患者中，3例HBAb复发，HBAg从血清中消失，另2例HBAg出现后仍存留。在所有3名在化疗开始时携带HBAg的患者中，骨髓抑制与HBAg滴度显著增加有关。HBAg滴度的升高与肝细胞损伤有关，表现为血清转氨酶的升高。这些观察表明，抗肿瘤化疗药物降低了HBAb效价。在一些患者中，HBAg出现在HBAb滴度下降之后。在既往存在HBAg的患者中，这种治疗会导致HBAg滴度的大幅增加。这种HBAg的出现或增加是否与抑制抗体形成，允许表达先前存在的抗原，或者与抑制细胞免疫，允许病毒增殖有关，尚不确定。
The effects of antitumor chemotherapeutic agents on hepatitis B antigen (HBAg) and antibody (HBAb) were studied serially in 25 patients with myeloproliferative and in 60 patients with lymphoproliferative disorders. HBAg was detected at some time in 17 patients, and HBAb in 40 patients. Seventeen patients who had HBAb detected immediately pretreatment had a decrease in HBAb titer which paralleled the fall in white blood cell count. In 5 of these patients, HBAg appeared when HBAb titers fell. In 3 of the 5 patients, a reappearance of HBAb was observed with disappearance of HBAg from the serum, and in the 2 other patients HBAg persisted once it appeared. In all 3 patients who had HBAg at the time of initiation of chemotherapy, bone marrow suppression was associated with a marked increase in HBAg titer. The increase in HBAg titer was associated with hepatocellular damage, as manifested by an elevation in serum transaminase enzymes. These observations suggest that antitumor chemotherapeutic agents reduce HBAb titers. In some patients, HBAg appears after a decrease in HBAb titers. In patients with preexisting HBAg, such therapy leads to large increases in HBAg titer. Whether this appearance or increase of HBAg is related to an inhibition of antibody formation, allowing expression of preexisting antigen, or to an inhibition of cellular immunity, allowing viral proliferation, is uncertain.