利妥昔单抗联合化疗后乙型肝炎病毒携带者肝功能异常临床分析(附5例报告)

Hepatic dysfunction in asymptomatic carrier of HBV after rituximab combinedwith chemotherapy in non-Hodgkin lymphoma patients (report of 5 cases)

目的探讨利妥昔单抗联合化疗治疗非霍奇金淋巴瘤(NHL)的效果及乙型肝炎(乙肝)病毒携带者肝功能异常的诊治。方法收集5例CD20阳性NHL合并乙肝史应用化疗联合利妥昔单抗的病例资料,观察利妥昔单抗的疗效、肝功能异常发生的时间及治疗情况。结果①肝功能异常多发生在停化疗>20d,血象逐渐恢复以后;②3例患者拉米夫定治疗有效,2例死亡。结论①利妥昔单抗联合化疗可能导致乙肝携带者肝功能异常;②一旦复发,应积极采用抗病毒等治疗方法;③预防较治疗更为重要,化疗过程中及停化疗后1年内应密切监测肝功能的变化,必要时预防性应用抗病毒药物。

To study the therapeutic efficacy and adverse effects of rituximab combined with chemotherapy in non-Hodgkin lymphoma （NHL） patients complicated with HBV infection. Methods Five cases of CD20 positive NHL were enrolled, the duration of liver dysfunction and the efficacy of the treatment regimen were observed. Results （1） The liver function was abnormal after 20 days of the chemotherapy ; （2） Lamifudine was effective in 3 cases, 2 patients dead. Conclusions （3） Rituximab combined with chemotherapy is sensitive to NHL, but increase the risk of hepatic dysfunction in asymptomatic of HBV carrier. （4） Antivirus treatment is effective. （5） Monitoring liver function and virus copy is important.