The combination of baseline HBV viral load (using real-time PCR) and clinical features provide a more sensitive and specific means of identifying patients who are at risk of developing HBV reactivation, and who would benefit most from lamivudine prophylaxis

The combination of baseline HBV viral load (using real-time PCR) and clinical features provide a more sensitive and specific means of identifying patients who are at risk of developing HBV reactivation, and who would benefit most from lamivudine prophylaxis. the agent was commonly coupled with folinic acid in gastrointestinal malignancies, it was also often used in combination with other cytotoxics that resulted in a variable degree 7-Epi-docetaxel of immunosuppression for non-gastrointestinal malignancies. Table 3 Tumour type treated with anthracyclines thead valign=”bottom” th align=”left” valign=”top” charoff=”50″ rowspan=”1″ colspan=”1″ ? /th th align=”center” valign=”top” charoff=”50″ rowspan=”1″ colspan=”1″ No. of patients with the tumour type /th th align=”left” valign=”top” charoff=”50″ rowspan=”1″ colspan=”1″ No. of patients treated with anthracyclines /th /thead 7-Epi-docetaxel Breast cancers3922 (56%)Lymphomas1210 (83%)Gastrointestinal cancers290Head 7-Epi-docetaxel and neck cancers170Lung cancers130Other cancers189 (50%) Open in a separate window Using the real-time PCR assay, which has a lower cutoff 7-Epi-docetaxel value of 2.9 103?g.e.?ml?1, the present study has revealed that detectable HBV DNA load prior to chemotherapy was a significant predictive factor for viral reactivation. Although a recent study has demonstrated that a detectable HBV DNA may predict HBV reactivation in HBsAg-positive individuals (Lau em et al /em , 2002), the finding, which was based on a small heterogeneous group of patients who underwent autologous hematopoietic cell transplantation, could not be generalised and applied to the majority of cancer patients who require conventional cytotoxic chemotherapy without transplantation. Prophylactic treatment with antiviral nucleotide analogue lamivudine prior to the start of chemotherapy has been suggested to be effective in reducing the incidence of HBV reactivation (Rossi em et al /em , 2001; Liao em et al /em , 2002; Lim em et al /em , 2002; Persico em et al /em , 2002; Shibolet em et al /em , 2002; Yeo em et al /em , 2002). The use of the proposed predictive model may aid the identification of high-risk patients who stand to benefit most from the antiviral, which could in turn be administered in a most cost-effective manner. We conclude that, in cancer patients who are positive for HBsAg and who undergo cytotoxic chemotherapy, high HBV viral load ( 2.9 103?g.e.?ml?1) prior to the administration of cytotoxic chemotherapy is a significant predictive factor for the development of HBV reactivation. Other factors that have been identified include the use 7-Epi-docetaxel of steroids and a diagnosis of lymphoma and breast cancer. The combination of baseline HBV viral load (using real-time PCR) and clinical features provide a more sensitive and specific means of identifying patients who are at risk Serpine2 of developing HBV reactivation, and who would benefit most from lamivudine prophylaxis. Although a predictive model has been formed to identify patients who are at risk of developing HBV reactivation in this study, there is a need to validate it in a separate cohort of patients before it can be safely applied in the clinical practice. Acknowledgments We thank research nurse Miss Jam Jun Lee and secretary Miss Candy Ho for their support in data collection..