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Leukemia & Lymphoma Volume 47, 2006 - Issue 1
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Case Report

Fatal hepatitis B virus reactivation in a chronic myeloid leukemia patient during imatinib mesylate treatment

K. Ikeda First Department of Internal Medicine, Fukushima Medical University, Fukushima, Japan; Division of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Japan
,
Y. Shiga Department of Hematology, Kita-Fukushima Medical Center, Fukushima, Japan
,
A. Takahashi Second Department of Internal Medicine, Fukushima Medical University, Fukushima, Japan
,
T. Kai Department of Hematology, Kita-Fukushima Medical Center, Fukushima, Japan
,
H. Kimura Department of Hematology, Kita-Fukushima Medical Center, Fukushima, Japan
,
K. Takeyama Division of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Japan
,
H. Noji First Department of Internal Medicine, Fukushima Medical University, Fukushima, Japan
,
K. Ogawa First Department of Internal Medicine, Fukushima Medical University, Fukushima, Japan
,
A. Nakamura First Department of Internal Medicine, Fukushima Medical University, Fukushima, Japan
,
H. Ohira Second Department of Internal Medicine, Fukushima Medical University, Fukushima, Japan
,
Y. Sato Second Department of Internal Medicine, Fukushima Medical University, Fukushima, Japan
&
Y. Maruyama First Department of Internal Medicine, Fukushima Medical University, Fukushima, JapanCorrespondence[email protected]
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Pages 155-157 | Received 20 Jun 2005, Published online: 01 Jul 2009
 
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Abstract

Reactivation of chronic hepatitis B virus (HBV) infection in patients undergoing chemotherapy is well-documented, but reactivation during imatinib mesylate treatment has not been reported. This study reports a 54-year-old man, without prior liver dysfunction but with chronic HBV infection, in whom fatal HBV reactivation occurred during treatment of chronic myeloid leukemia (CML) with imatinib mesylate. He developed fulminant hepatitis followed by marked elevation of HBV DNA polymerase, probably from the lymphocytopenic and immunosuppressive status induced by imatinib mesylate. Imatinib mesylate is widely used to treat CML patients. Although therapy with imatinib mesylate is generally well tolerated, the case presented here suggests that viral reactivation should be considered, even when using imatinib mesylate to treat CML.

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