Table 2.
HBV reactivation in patients who received BTK inhibitors
| Patient 1 (current study) |
Patient 2 (current study) |
Patient 3 (previous report)8 |
|
|---|---|---|---|
| Baseline characteristics | |||
| Age, years | 92 | 66 | 68 |
| Sex | Female | Male | Male |
| Cancer | CLL | MCL | MZL |
| History of anti-CD20 MoAb therapy | Yes | Yes | Yes |
| HBsAg / Anti-HBs results | + / − | − / − | − / − |
| HBV DNA, log IU/mL | NA | Undetectable | Undetectable |
| BTK inhibitor administration before HBV reactivation | |||
| BTK inhibitor | Acalabrutinib | Acalabrutinib | Ibrutinib |
| Concomitant cancer treatment | No | Venetoclax | No |
| Treatment duration, months | 2 | 21 | 6 |
| Cumulative dose, mg | 12,000 | 126,000 | 100,800 |
| Laboratory data at time of HBV reactivation | |||
| Lymphocyte count, cells/mL | 38,270 | 800 | 1,670 |
| Bilirubin, mg/dL | 0.5 | 10.6 | 5.3 |
| AST / ALT, U/L | 103/135 | 1,057/1,160 | 872/1293 |
| INR | 1.06 | 1.01 | 1.09 |
| HBsAg | + | − | + |
| HBV DNA, IU/mL | 7.11 | 8.62 | 5.83 |
| HBV-associated adverse outcomes | |||
| HBV-associated hepatitisa | Yes | Yes | Yes |
| HBV-associated liver failurea | No | Yes | Yes |
| Antiviral therapy and outcome | |||
| Antiviral therapy | Entecavir | Entecavir | Entecavir |
| Survival at last follow-up | Alive | Alive | Alive |
| BTK inhibitor continued | Yes | No | No |
| Follow-up time, months | 25 | 4 | 47 |
Abbreviations: +, positive; −, negative; ALT, alanine transaminase; anti-HBc: hepatitis B core antibody; AST, aspartate transaminase; BTK, Bruton tyrosine kinase; CLL, chronic lymphocytic leukemia; HBsAb, hepatitis B surface antibody; HBsAg, hepatitis B surface antigen; INR, international normalized ratio; MCL, mantle cell lymphoma; MoAb, monoclonal antibody; MZL, marginal zone lymphoma; NA, not available.
a.
Defined in the Methods section.