chemotherapy for hematologic malignancies

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Occurrence during chemotherapy for hematologic malignancies.  Anna Maria Pelizzari and colleagues reviewed 32 courses of primary lamivudine prophylaxis given to 23 adult HBV carriers with hematologic malignancies who underwent chemotherapy in order to determine the frequency and clinical significance of the occurrence of HBV YMMD mutants.  Lamivudine was administered for a median of 6 months (range, 2-24+ months).  After a median follow-up time of 19.5 months (range, 5-40 months), 4 episodes of HBV reactivation with mild hepatitis were observed.  YMMD mutation (associated with normal aminotransferase levels) was detected in only one patient who had received lamivudine continuously for 20 months (3.1% of prophylactic lamivudine courses).  Prophylactic lamivudine treatment during chemotherapy for patients with hematologic malignancies was associated with a low frequency of YMMD mutant development that was of little clinical significance; this may be related to low pretreatment HBV DNA levels and the short duration of lamivudine treatment in many of the patients.  (Pelizzari AM, et al. The Hematology Journal 2004; 5:325-328)