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| 1 | Prevention and management of hepatitis B virus reactivation in patients with hematological malignancies treated with anticancer therapy显示文摘Hepatitis due to hepatitis B virus(HBV) reactivation can be severe and potentially fatal, but is preventable. HBV reactivation is most commonly reported in patients receiving cancer chemotherapy, especially rituximabcontaining therapy for hematological malignancies and those receiving stem cell transplantation. All patients with hematological malignancies receiving anticancer therapy should be screened for active or resolved HBV infection by blood tests for hepatitis B surface antigen(HBs Ag) and antibody to hepatitis B core antigen(antiHBc). Patients found to be positive for HBs Ag should be given prophylactic antiviral therapy to prevent HBV reactivation. For patients with resolved HBV infection, no standard strategy has yet been established to prevent HBV reactivation. There are usually two options. One is pre-emptive therapy guided by serial HBV DNA monitoring, whereby antiviral therapy is given as soon as HBV DNA becomes detectable. However, there is little evidence regarding the optimal interval and period of monitoring. An alternative approach is prophylactic antiviral therapy, especially for patients receiving highrisk therapy such as rituximab, newer generation of anti-CD20 monoclonal antibody, obinutuzumab or hematopoietic stem cell transplantation. This strategy may effectively prevent HBV reactivation and avoid the inconvenience of repeated HBV DNA monitoring. Entecavir or tenofovir are preferred over lamivudine as prophylactic therapy. Although there is no well-defined guideline on the optimal duration of prophylactic therapy, there is growing evidence to recommend continuing prophylactic antiviral therapy for at least 12 mo after cessation of chemotherapy, and even longer for those who receive rituximab or who had high serum HBV DNA levels before the start of immunosuppressive therapy. Many novel agents have recently become available for the treatment of hematological malignancies, and these agents may be associated with HBV reactivation. Although there is currently limited evidence to guide the optimal preventive measures, we recommend antiviral prophylaxis in HBs Ag-positive patients receiving novel treatments, especially the Bruton tyrosine kinase inhibitors and the phosphatidylinositol 3-kinase inhibitors, which are B-cell receptor signaling modulators and reduce proliferation of malignant B-cells. Further studies are needed to clarify the risk of HBV reactivation with these agents and the best prophylactic strategy in the era of targeted therapy for hematological malignancies. | Man Fai Law Rita Ho Carmen KM Cheung Lydia HP Tam Karen Ma Kent CY So Bonaventure Ip Jacqueline So Jennifer Lai Joyce Ng Tommy HC Tam | 2016 | World Journal of Gastroenterology2016，22，28： | 10 |
| 2 | 酪氨酸激酶抑制剂致慢性髓系白血病患者乙肝再激活1例并文献复习显示文摘0引言酪氨酸激酶抑制剂(tyrosine kinase inhibitor,TKI)作为一类针对酪氨酸激酶的分子靶向治疗药物,已成为慢性髓系白血病(chronic myelogenous leukemia,CML)患者药物治疗的首选。近年来出现了合并慢性HBV感染的CML患者接受TKI治疗后发生乙肝再激活的报道,引起医疗工作者对该药物靶向外不良反应的关注。基于此, | 赵攀 谭竞 魏锦 | 2015 | 肿瘤防治研究2015，42，1： | 4 |
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