Antiviral Therapy and Hepatitis B Reactivation Outcomes in Chronic Myeloid Leukemia Treated with Tyrosine Kinase Inhibitors: A Retrospective Cohort Study

Objectives: Viral Hepatitis reactivation can occur in patients receiving tyrosine kinase inhibitors (TKIs), with potentially fatal complications. We aimed to assess hepatitis reactivation in patients with chronic myeloid leukemia (CML) treated with TKIs. Methods: We retrospectively reviewed the clinical and laboratory records, including antiviral therapy and hepatitis testing data, of CML patients treated with TKI at Sultan Qaboos University Hospital between 2006 and 2020. Results: The participants comprised 98 Omani CML patients who underwent TKI therapy (mean age = 41.1 years; range = 4–77 years). No cases met study criteria for viral hepatitis reactivation during TKI therapy. Imatinib was the first-line CML therapy for 87 (88.8%) patients; Imatinib was used as first line in 93 (94.9%) patients; most patients subsequently switched to other TKIs. Anti-HBc was positive at baseline in 16 (16.3%) patients of whom six with hepatitis B surface antigen-positivity were treated with antivirals along with TKIs, with positive outcomes. The only hepatitis C virus positive CML patient in the cohort also achieved long-term remission from both with combined interferon therapy and TKI. The overall mortality rate was nine (9.2%). Conclusions: In this cohort of Omani patients, no hepatitis B virus or hepatitis C virus reactivation case was documented in association with TKI therapy.