Successful long-term control with lamivudine against reactivated hepatitis B infection following intensive chemotherapy and autologous peripheral blood stem cell transplantation in non-Hodgkin's lymphoma: experience of 2 cases.

It is well documented that cytotoxic treatment in patients carrying the hepatitis B virus (HBV) enhances the risk of severe hepatic damage. Recently lamivudine has been reported to be effective in suppressing the replication of HBV under such conditions. Here we report two cases with HBV carrier status and with non-Hodgkin's lymphoma who were successfully treated with high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation with the administration of lamivudine to prevent HBV flare-up. The antiviral effect of lamivudine was fair, and no objective side effect was experienced during the transplant procedure. Both patients were followed carefully for more than a year without the appearance of the resistant virus. The rebound phenomenon in which HBV proliferates abruptly has not been experienced after withdrawal of lamivudine. We suggest that lamivudine is indicated both in the treatment of HBV viremia and in the prevention of proliferation of HBV in patients with HBV carrier status undergoing high-dose myeloablative chemotherapy.