血液恶性瘤化疗期间儿童的B型肝炎再激活:包括长期随访在内的24例病例的经验
Harshad Devarbhavi1, Mallikarjun Patil1
1Department of Gastroenterology and Hepatology, St. John's Medical College Hospital, Bangalore, India.
Journal of clinical and experimental hepatology
|December 24, 2025
概括
在患有血液性恶性瘤的儿童中,乙型肝炎病毒 (HBV) 感染或化疗期间的活性化可能会导致严重的肝炎. 然而,早期的抗病毒治疗带来了良好的结果,儿童患者没有发现肝衰竭病例.
科学领域:
- 儿科瘤学 儿科瘤学
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
背景情况:
- 乙型肝炎病毒 (HBVr) 再激活或急性感染是已知的成年人化疗并发症,但儿科数据有限.
- 这项研究涉及急性HBV感染或HBVr的临床形状,病程和结果,在接受血液恶性瘤化疗的儿童中.
研究的目的:
- 评估急性乙型肝炎病毒 (HBV) 感染或重新激活在接受化疗的儿科患者的临床特征和结果.
- 评估HBV感染/重新激活对患有血液恶性瘤的儿童治疗方案和长期肝脏健康的影响.
主要方法:
- 在化疗期间 (2005-2023) 患有急性乙型肝炎或HBVr的24名儿童 (4-15岁) 的分析.
- 通过新检测HBsAg和/或HBVDNA与ALT升高来定义HBVr;通过ALT>5xULN,黄或升高的胆红素来确定严重的肝炎.
- 监测化疗中断,抗病毒疗法和长期结果,直到2024年12月.
主要成果:
- 在24名儿童中,23名患有严重的肝炎,22名儿童需要暂停化疗.
- 所有患者都接受了抗病毒疗法,实现了生化改善;4名儿童经历了HBsAg血清转化.
- 没有孩子患有肝衰竭,肝硬化或纤维化胆固醇性肝炎;三例死亡是由于恶性瘤复发.
结论:
- 在化疗期间患有HBV感染/重新激活的儿科患者经历了严重的肝炎,但在早期抗病毒治疗时取得了良好的结果.
- 抗病毒疗法促进了肝脏的恢复,并允许及时恢复化疗,最小的中断.
- 与成年人相比,儿童表现出更强的肝复原力,没有肝衰竭或肝硬化病例.
相关概念视频
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
171
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
171
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
191
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
191
01:22Bone Marrow Sampling and Transplants
809
Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
809