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Evaluation of Hepatitis B and C reactivation in patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors

Grant number: 19/18291-8
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): October 01, 2019
Effective date (End): November 30, 2020
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Katia Borgia Barbosa Pagnano
Grantee:Nathalia Sena de Oliveira Silva
Home Institution: Centro de Hematologia e Hemoterapia (HEMOCENTRO). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil


Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of the Philadelphia chromosome (Ph) resulting from the translocation between the long arms of chromosome 9 and 22 which causes the juxtaposition of the ABL and BCR genes. This phenomenon produces a BCR-ABL chimeric protein with increased constitutive tyrosine kinase activity, which enhances cell proliferation and inhibits apoptosis. The first-line treatment established for CML is targeted therapy with tyrosine kinase inhibitors (TKI). These drugs, however, suppress the immune system and allow the reactivation of viral hepatitis B and C, which may cause acute liver dysfunction. The study of TKI-induced reactivation becomes even more relevant in the current scenario of increased prevalence of CML. Considering this context, the present study aims to evaluate the frequency of hepatitis B and C in the CML population before and after TKI treatment. First, a retrospective analysis will be performed with data collection of patients treated at Hematology and Hemotherapy Center, Unicamp, to investigate the prevalence of viral hepatitis at diagnosis of CML and the reactivation of these infectious diseases during treatment. The second analysis will be a prospective assessment of the serological status of CML patients undergoing treatment with TKI for at least 5 years, to determine if hepatitis B or C reactivation has occurred.