Reactivation of resolved infection with the hepatitis B virus immune escape mutant G145R during dasatinib treatment for chronic myeloid leukemia

Int J Hematol. 2015 Sep;102(3):379-82. doi: 10.1007/s12185-015-1788-y. Epub 2015 Apr 5.

Abstract

Reactivation of hepatitis B virus (HBV) following immunosuppressive therapy or hematopoietic stem cell transplantation is a potentially fatal complication that may occur even in patients with prior resolution of HBV infection. Dasatinib is a small-molecule inhibitor of the tyrosine kinases SRC and ABL that has been approved for the treatment of chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia. Here, we report the first case of reactivation of resolved infection with the HBV immune escape mutant G145R in a CML patient receiving dasatinib. Although dasatinib is not recognized as an immunosuppressant, our observations suggest that dasatinib may enhance HBV replication and induce its reactivation in immunocompetent patients, that HBV escape mutants may contribute to the pathogenesis of HBV reactivation, and that close monitoring of HBV status is advisable in patients with current or resolved HBV infection.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amino Acid Substitution
  • Dasatinib / administration & dosage
  • Dasatinib / adverse effects*
  • Female
  • Hepatitis B virus / physiology*
  • Hepatitis B* / genetics
  • Hepatitis B* / immunology
  • Humans
  • Immune Evasion* / drug effects
  • Immune Evasion* / genetics
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / immunology
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / virology
  • Mutation, Missense*
  • Virus Activation* / drug effects
  • Virus Activation* / genetics
  • Virus Activation* / immunology

Substances

  • Dasatinib