ACUTE HEPATIC-INJURY AFTER DISCONTINUATION OF CHEMOTHERAPY IN A PATIENT WITH NON-HODGKINS-LYMPHOMA AND CHRONIC HEPATITIS-B VIRUS-INFECTION

We describe a HBsAg-positive patient with non-Hodgkin's lymphoma who u nderwent aggressive chemotherapy. After discontinuation of chemotherap y, he developed jaundice due to a reactivation of the hepatitis B. Ser um HBeAg and HBV DNA turned positive, indicating active virus replicat ion. Abdominal CT-scan showed a large solitary tumour mass in the live r and the serum a-fetoprotein level was extremely high, suggesting HBV -related hepatoma. After discontinuation of chemotherapy, the patient died of non-Hodgkin's lymphoma and hepatocellular carcinoma. Throughou t treatment of HBsAg-positive patients with cytotoxic or immunosuppres sive therapy, careful monitoring of serum aminotransferase levels and HBV DNA is essential. Aggressive chemotherapy may have to be discontin ued or changed to a milder regimen if hepatitis occurs.