Anti-CD20 monoclonal antibodies and associated viral hepatitis in hematological diseases

• 作者: Ann-Lii Cheng Chiun Hsu Shih-Hung Yang Sung-Hsin Kuo
• 来源期刊: 世界血液学杂志
• 学科: 医学
• 关键词: CD20 MONOCLONAL antibody HEPATITIS HEPATITIS B VIRUS HEPATITIS C VIRUS
• 年，卷（期）: 2014,（2）
• 页码范围: 29-43
• 页数: 15页
• 分类号: R

摘要

Over the past decade,the administration of anti-CD20 monoclonal antibodies such as rituximab has demonstrated various degrees of effectiveness and has improved patients’outcomes during the treatment of autoimmune hematological disorders and hematological malignancies.However,the depletion of B-cells,the distribution of T-cell populations,and the reconstruction of host immunity resulting from the use of anti-CD20 monoclonal antibodies potentially lead to severe viral infections,such as hepatitis B virus(HBV),hepatitis C virus(HCV),parvovirus B19,and herpes viruses,in patients who are undergoing immune therapy or immunochemotherapy.Of these infections,HBV-and HCV-related hepatitis are a great concern in endemic areas because of the high morbidity and mortality rates in untreated patients.As a result,prophylaxis against HBV infection is becoming a standard of care in these areas.Parvovirus B19,a widespread pathogen that causes red blood cell aplasia in immunocompromised hosts,also causes hepatitis in healthy individuals.Recently,its association with hepatitis was recognized in a patient treated with rituximab.In addition,adenovirus,varicella-zoster virus,hepatitis E virus,and rituximab itself have been linked to the occurrence of hepatitis during or after rituximab treatments.The epidemiologies and pathogeneses of these etiologies remain unknown.Because of the increasing use of anti-CD20 monoclonal antibodies for the treatment of hematological malignancies or autoimmune hematological disorders,it is imperative that physicians understand and balance the risks of hepatotropic virusassociated hepatitis against the benefits of using anti-CD20 monoclonal antibodies.