Clearance of HBsAg in a patient with familial multiple myeloma after a bortezomib-based regimen combined with anti-HBV drug: A case report

Reactivation of hepatitis B virus (HBV) after treatment with bortezomib-based regimens in HBV-positive patients with multiple myeloma (MM) has been reported in the past few years. Nevertheless, there is evidence of inhibition of HBV replication by bortezomib in transgenic mice. However, there is sti...

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Bibliographic Details
Published in:Medicine (Baltimore) 2020-10, Vol.99 (40), p.e22642-e22642
Main Authors: Zhang, Xuzhao, Liang, Yun, Li, Xian, Wang, Weiqin, Tong, Jiefeng, Xu, Yang
Format: Article
Language:English
Subjects:
Antineoplastic Agents - therapeutic use
Antiviral Agents - therapeutic use
Bortezomib - therapeutic use
Clinical Case Report
Clinical Protocols
Drug Therapy, Combination
Guanine - analogs & derivatives
Guanine - therapeutic use
Hematopoietic Stem Cell Transplantation - methods
Hepatitis B Surface Antigens - drug effects
Hepatitis B virus - drug effects
Hepatitis B virus - genetics
Hepatitis B, Chronic - complications
Hepatitis B, Chronic - prevention & control
Hepatitis B, Chronic - virology
Humans
Male
Middle Aged
Multiple Myeloma - drug therapy
Transplantation, Autologous - methods
Treatment Outcome
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Summary:Reactivation of hepatitis B virus (HBV) after treatment with bortezomib-based regimens in HBV-positive patients with multiple myeloma (MM) has been reported in the past few years. Nevertheless, there is evidence of inhibition of HBV replication by bortezomib in transgenic mice. However, there is still no clinical evidence that bortezomib inhibits HBV. A 55-year-old MM patient with a family history of MM, who was also a chronic HBV carrier, achieved HBV clearance after treatment with a bortezomib-based regimen in combination with anti-HBV drugs. The diagnosis was MM with chronic carrier of HBV. He received bortezomib-based regimen for MM as well as entecavir as a prophylaxis to prevent HBV reactivation. This patient achieved HBsAg and HBV-DNA clearance after 2 months and the remission was maintained during the next 2 years. He also achieved complete remission of MM and underwent consolidation therapy with autologous hematopoietic stem cell transplantation. This is the first case of MM with HBV clearance after receiving a bortezomib-based regimen combined with anti-HBV drug. Research on related mechanisms might provide new suggestions and hope for better management of HBV positive patients with MM and for the treatment of HBV patients.
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000022642