Fulminant hepatitis in a hepatitis B surface antigen‐positive patient with adult T‐cell leukemia‐lymphoma after mogamulizumab monotherapy

Author:

Nakashima Takahiro1,Kusumoto Shigeru12,Ishida Takashi3,Kato Chie1,Hagiwara Shinya1,Narita Tomoko1,Masaki Ayako4,Ito Asahi1,Ri Masaki1,Komatsu Hirokazu1,Inagaki Hiroshi4,Tanaka Yasuhito5ORCID,Iida Shinsuke1

Affiliation:

1. Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan

2. Department of Hematology and Cell Therapy Aichi Cancer Center Hospital Nagoya Japan

3. Department of Immunology Nagoya University Graduate School of Medicine Nagoya Japan

4. Department of Anatomic Pathology and Molecular Diagnostics Nagoya City University Graduate School of Medical Sciences Nagoya Japan

5. Department of Gastroenterology and Hepatology Faculty of Life Sciences Kumamoto University Kumamoto Japan

Abstract

AbstractWe report a case of fulminant hepatitis in a hepatitis B surface antigen (HBsAg)‐positive patient with aggressive adult T‐cell leukemia‐lymphoma who received monotherapy with an anti‐CCR4 monoclonal antibody, mogamulizumab, with decreased hepatitis B virus (HBV)‐ DNA levels by entecavir prophylaxis. Although HBV reactivation‐related hepatitis was considered in the differential diagnosis, the patient did not meet the conventional criteria for HBV reactivation and was finally diagnosed with drug‐induced hepatitis. Considering that the immunoenhancing effects of mogamulizumab can lead to HBV reactivation‐related hepatitis in HBsAg‐positive patients, we should differentiate drug‐induced hepatitis from HBV reactivation, especially in patients receiving immunomodulatory drugs, if HBV‐DNA levels are reduced by antiviral prophylaxis.

Publisher

Wiley

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