Antiviral prophylaxis for hepatitis B carriers improves the prognosis of diffuse large B‐cell lymphoma in Taiwan – a population‐based study

Huang, Huai-Hsuan; Hsiao, Fei‐Yuan; Chen, Ho‐Min; Wang, Chenyu; Ko, Bor-Sheng

doi:10.1111/bjh.17142

Cited by 10 publications

(13 citation statements)

References 21 publications

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“…To our knowledge, this is one of the few studies to examine whether the presence of HBV infection affected the clinical characteristics and outcomes in patients with DLBCL, our study included 127 HBsAg-positive patients, which was one of the largest number of patients in all studies of this disease. In our study, HBV prevalence in DLBCL patients was approximately 30.2%, which was similar or higher than the 13.3%–30.9% observed in previous studies from China, Taiwan, Singapore, and another Asian country [ 9 , 11 , 24 , 29 , 31 , 33 – 35 ]. These results suggested that in HBV-prevalent regions, a certain percentage of DLBCL patients are chronically infected with HBV.…”

Section: Discussionsupporting

confidence: 85%

“…The latest report by Huang et al displayed that the mOS of HBV-negative and HBV carriers who received antiviral prophylaxis was similar. However, the mOS of HBV carriers who did not receive antiviral prophylaxis was significantly shorter than HBV carriers who received antiviral prophylaxis, indicating that antiviral prophylaxis improves OS in HBsAg-positive DLBCL patients [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…While the epidemiological association between HBV infection and DLBCL is established, few articles have systematically investigated the clinicopathological characteristics and adverse prognostic factors of DLBCL patients with HBV infection. Some researchers reported that the survival of DLBCL patients with HBV infection is poor compared with DLBCL patients without HBV infection [ 24 – 29 ], while others found that, in both HBsAg-positive and -negative DLBCL patients, the median overall survival (OS) is similar [ 30 , 31 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinicopathological and prognostic features of hepatitis B virus-associated diffuse large B-cell lymphoma: a single-center retrospective study in China

Chen

Wang

et al. 2021

Infect Agents Cancer

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Background While the epidemiologic association between hepatitis B virus (HBV) infection and diffuse large B-cell lymphoma (DLBCL) is established, little is known about the pathological characteristics and outcome of DLBCL arising in patients with HBV infection. Methods We retrospectively studied a cohort of 420 patients with DLBCL for the incidence of HBV infection, and the clinicopathologic features and prognostic factors in HBsAg-positive DLBCL patients in China, a hepatitis B endemic area. Results In our study, 127 (30.2%) patients were HBsAg-positive. HBsAg-positive DLBCL displayed a younger median onset age (50 vs. 54 years, P = 0.002), more frequent involvement of the spleen (19.7% vs. 6.1%, P < 0.001), less frequent involvement of the small and large intestine (2.3% vs. 11.2%, P = 0.003), more advanced disease (stage III/IV: 56.7% vs. 45.1%, P = 0.028), and lower expression rate of MYC (49.1% vs. 66.7%, P = 0.026). The median follow-up time was 61.9 months. Univariate analysis showed that there was no significant difference in overall survival (OS) between HBsAg-negative and -positive DLBCL (P = 0.577). In the HBsAg-positive DLBCL subgroup, age older than 60 years, advanced disease, elevated lactate dehydrogenase (LDH), spleen involvement, B symptoms (fever, night sweats, weight loss), and double expressers of MYC and BCL2 had a significantly worse outcome, and patients treated with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) had a better prognosis. Multivariate analysis further confirmed that spleen involvement and rituximab use were independent prognostic factors in HBsAg-positive DLBCL patients. Conclusions Our study indicates that HBsAg-positive DLBCL has unique clinicopathological features and independent prognostic factors. Moreover, under antiviral prophylaxis, the survival of DLBCL patients with HBV infections was comparable to that of HBV-negative patients, and the use of rituximab significantly improved OS in HBsAg-positive DLBCL patients.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinicopathological and prognostic features of hepatitis B virus-associated diffuse large B-cell lymphoma: a single-center retrospective study in China

Chen

Wang

et al. 2021

Infect Agents Cancer

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“…Correspondingly, patients with DLBCL and active HBV infection had similar outcomes to uninfected patients when they received immunochemotherapy and antivirals. A population-based study ( 24 ) indicated those patients with DLBCL and HBV infection had comparable survival outcome than those without HBV infection (median OS, not reached vs. 74.23 months, respectively) when antiviral prophylaxis was used. Another study ( 25 ) compared the treatment responses and survival between 116 patients with HBsAg-positive DLBCL and 278 patients with HBsAg-negative DLBCL, all of whom received rituximab-based therapy.…”

Section: Discussionmentioning

confidence: 99%

Effect of infection with hepatitis B virus on the survival outcome of diffuse large B-cell lymphoma in the prophylactic antiviral era

Nuersulitan

Li²,

Mi³

et al. 2022

Front. Oncol.

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Patients with lymphoma who are also infected with Hepatitis B virus (HBV) have a poor prognosis. This could be partly explained by the delay or premature termination of anti-tumor treatment because of HBV reactivation. However, there is limited data on the survival outcome of patients HBV-related lymphoma in the era of prophylactic antivirals. Data for 128 patients with HBV surface antigen-positive diffuse large B-cell lymphoma was collected. The median age was 54 years and the ratio of men to women was 1.2:1. All patients received immune-chemotherapy and prophylactic antiviral therapy. The median number of cycles of immune-chemotherapy was six. The overall response rate was 82%, with a complete remission rate of 75%. With a median follow-up of 58.4 months, the 5-year progression-free survival and overall survival rates were 75.7% and 74.7%, respectively. Nine patients experienced HBV reactivation but none experienced HBV-associated hepatitis. Patients with low and high HBV DNA loads had comparable survival outcomes. In conclusion, HBV infection had no negative effect on the prognosis of DLBCL in the era of prophylactic antiviral therapy.

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“…Lymphoma is a primary malignant tumor of lymph nodes or lymph tissues, and its occurrence may be related to gene mutations (Zahn et al, 2020), virus and other pathogen infections (Huang et al, 2021). Studies highlight the roles of clonally diverse CD4 T cells and innate effectors in the efficacy of PD-1 blockade in classical Hodgkin lymphomas (Cader et al, 2020).…”

Section: Lymphomamentioning

confidence: 99%

Effects of Tumor-Derived Exosome Programmed Death Ligand 1 on Tumor Immunity and Clinical Applications

Shao

Dang

Chen

et al. 2021

Front. Cell Dev. Biol.

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Programmed death ligand 1 (PD-L1) is a typical immune surface protein that binds to programmed cell death 1 (PD-1) on T cells through its extracellular domain. Subsequently, T cell activity is inhibited, and tumor immune tolerance is enhanced. Anti-PD-1/PD-L1 immune checkpoint therapy blocks the combination of PD-1/PD-L1 and rejuvenates depleted T cells, thereby inhibiting tumor growth. Exosomes are biologically active lipid bilayer nanovesicles secreted by various cell types, which mediate signal communication between cells. Studies have shown that PD-L1 can not only be expressed on the surface of tumor cells, immune cells, and other cells in the tumor microenvironment, but also be released from tumor cells and exist in an extracellular form. In particular, exosome PD-L1 plays an unfavorable role in tumor immunosuppression. The immunomodulatory effect of exosome PD-L1 and its potential in fluid diagnosis have attracted our attention. This review aims to summarize the available evidence regarding the biological characteristics of exosome PD-L1 in tumor immunity, with a particular focus on the mechanisms in different cancers and clinical prospects. In addition, we also summarized the current possible and effective detection methods for exosome PD-L1 and proposed that exosome PD-L1 has the potential to become a target for overcoming anti-PD-1/PD-L1 antibody treatment resistance.

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Antiviral prophylaxis for hepatitis B carriers improves the prognosis of diffuse large B‐cell lymphoma in Taiwan – a population‐based study

Cited by 10 publications

References 21 publications

Clinicopathological and prognostic features of hepatitis B virus-associated diffuse large B-cell lymphoma: a single-center retrospective study in China

Clinicopathological and prognostic features of hepatitis B virus-associated diffuse large B-cell lymphoma: a single-center retrospective study in China

Effect of infection with hepatitis B virus on the survival outcome of diffuse large B-cell lymphoma in the prophylactic antiviral era

Effects of Tumor-Derived Exosome Programmed Death Ligand 1 on Tumor Immunity and Clinical Applications

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