According to research presented at the annual meeting of the American Society of Hematology, in at least one major academic medical center, far too many cancer patients are receiving rituximab without being screened for the hepatitis B virus (HBV).
Researchers from the University of Massachusetts Medical School reviewed the charts of patients receiving cancer treatment at UMass Memorial Health Care in Worcester, Mass., from 2009 to 2011 to see whether the medical center was heeding the recommendation made by several influential organizations, including the American Society of Clinical Oncology (ASCO) and the American Association for the Study of Liver Disease (AASLD), to screen patients for HBV infection either before or shortly after beginning to administer rituximab.
Rituximab may reactivate latent HBV infection
The well-known anti-CD20 monoclonal antibody works by selectively targeting B-lymphocytes and depleting the body of them. As a consequence, latent HBV infection in a patient can be reactivated.
Researchers determined that only 51.4% were screened for HBV infection at some point before or shortly after rituximab was initiated. On top of that, only half of those patients were tested within the acceptable window: nine months prior to infusion or up to 30 days following infusion.
While the total number of charts that were reviewable amounted to only 103, only 53 of those patients were screened for HBV—at any time in their chart. Seven were screened in the nine months leading up to initiation of the drug, and 19 were screened within 30 days after initiation.
Fortunately, no cases of HBV reactivation were found in the charts, but researchers stressed that other medical centers should review their protocols to see to it that this important recommendation is being followed.