Hepatitis B Virus Reactivation with Ibrutinib Treatment in a Patient with Chronic Lymphocytic Leukemia: A Case Report and Literature Review

Abstract

Chronic lymphocytic leukemia (CLL) is a common hematological neoplasm in adults with an abnormal increase in monoclonal B lymphocytes. Ibrutinib is a small molecule class oral cancer drug that inhibits Bruton's tyrosine kinase (BTK) enzyme. They are widely used for treating CLL. Ibrutinib suppresses peripheral lymphocytes, causing both lymphopenia and neutropenia. It has little effect on serum immunoglobulin levels and reportedly does not cause reactivation of tuberculosis or opportunistic infections. Hepatitis B prophylaxis during treatment remains controversial. However, there have been cases of acute liver failure and severe hepatitis B reactivation associated with its widespread use. In this case report, we report a patient with no previous history of immunosuppressive therapy who developed hepatitis B reactivation in the early period after ibrutinib treatment for CLL.