Clinical and prognostic analysis of hepatitis B virus infection in diffuse large B-cell lymphoma

Wang, Feng; Xu, Rui‐Hua; Luo, Hui; Zhang, Dong Shen; Jiang, Wen Qi; Huang, Hui Qiang; Sun, Xiao Fei; Xia, Zhong Jun; Guan, Zhong

doi:10.1186/1471-2407-8-115

Cited by 59 publications

(63 citation statements)

References 29 publications

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“…The present study demonstrated an earlier age of disease onset in the HBsAg-positive DLBCL patient group. These two facts suggest that HBV acts as an etiologic factor for DLBCL development, which is in agreement with the results of an earlier relevant study; however, an apparent correlation between HBsAg and prognosis was not revealed in the earlier study (23). The current study demonstrated that HBsAg-positive DLBCL patients had poorer OS rates compared with HBsAg-negative patients (62.2% HBsAg-positive vs. 76.2% HBsAg-negative, P=0.018; Fig.…”

Section: Discussionsupporting

confidence: 90%

Clinical analysis and prognostic significance of hepatitis B virus infections for diffuse large B-cell lymphoma with or without rituximab therapy

Xie

Zhou

et al. 2013

Experimental and Therapeutic Medicine

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The aim of this study was to analyze the clinical features of hepatitis B surface antigen (HBsAg)-positive and negative diffuse large B-cell lymphomas (DLBCLs) and to compare the outcomes and serum hepatitis B virus (HBV)-DNA loads of patients treated with cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) regimens with rituximab (RCHOP) or without. A total of 451 DLBCL patients, of which 90 were HBsAg-positive and 361 were HBsAg-negative, were retrospectively reviewed. We compared onset age, gender, Ann Arbor stage, international prognostic index (IPI), lactate dehydrogenase (LDH) and β2-microglobulin (β2-M) levels, as well as overall survival (OS) rates and HBV-DNA loads under CHOP or RCHOP regimens. The OS rate of the HBsAg-positive DLBCL patients was significantly lower than that of HBsAg-negative DLBCL patients and the HBsAg-positive DLBCL patients had an earlier median onset age. HBsAg-positive DLBCL patients had poorer OS rates compared with HBsAg-negative patients (62.2% HBsAg-positive vs. 76.2% HBsAg-negative, P=0.018). HBsAg-positive DLBCL patients with HBV-DNA loads >103 cps/ml during chemotherapy had significantly lower OS rates than those with lower HBV-DNA loads (48.4% HBV-DNA elevated vs. 71.2% HBV-DNA normal, P=0.037). HBsAg-positive DLBCL patients treated with RCHOP had a significantly higher OS rate (79.6%) compared with the 41 CHOP-treated patients (43.9%; P<0.001). HBsAg-positive DLBCL patients with an earlier median onset age and elevated HBV-DNA during chemotherapy had poorer prognoses. HBsAg and HBV-DNA during chemotherapy may be used as prognostic indicators for patients with DLBCL. Rituximab improves the outcome of HBsAg-positive DLBCL patients when administered in combination with anti-viral lamivudine.

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Section: Discussionsupporting

confidence: 90%

Clinical analysis and prognostic significance of hepatitis B virus infections for diffuse large B-cell lymphoma with or without rituximab therapy

Xie

Zhou

et al. 2013

Experimental and Therapeutic Medicine

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“…Although some autoimmune diseases show a clear tendency towards MALT lymphomas (such as Sjogren’s syndrome and Hashimoto’s thyroiditis), most of the lymphomas in SLE (as well as RA) are of the diffuse large B-cell type. As a caveat to this, there has been recent evidence suggesting that hepatitis B may play a role in the development of diffuse large B-cell lymphoma, in a Chinese general population sample(46). To date however, there is very little evidence of a strong role for infectious agents as mediators of lymphoma risk in SLE.…”

Section: Hematological Malignancies and Inflammationmentioning

confidence: 99%

Malignancy in systemic lupus erythematosus: what have we learned?

Bernatsky

Ramsey‐Goldman

Clarke

2009

Best Practice & Research Clinical Rheumatology

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What have we learnt about cancer risk in systemic lupus erythematosus (SLE) over the past decade? One important lesson is that data do confirm a slight increased risk in SLE for all cancers combined, compared to the general population. However, it is clear that this is largely driven by an increased risk for hematological malignancies, particularly non-Hodgkin's lymphoma (NHL), although Hodgkin's lymphoma may be increased as well. In addition, there is evidence for a moderately increased risk of lung cancer, and possibly for rarer cancer types, such as hepatobiliary and vulvar/ vaginal malignancies.Unfortunately, the most clinically relevant question, the mechanism underlying the association between cancer and SLE, remains largely unanswered. Key issues remaining under study relate to the links between cancer risk, SLE disease activity, and medication exposures. Much of the recent data suggest that disease-related factors may be at least as important as medication exposures for certain cancers, such as NHL. The independent effects of drug exposures versus disease activity in mediating cancer risk in SLE remain unknown. Work is in progress to further elucidate these important issues.Meanwhile, there is good evidence that cervical dysplasia is increased in women with SLE. This may be mediated by decreased clearance of the human papilloma virus, which some suggest is an innate characteristic of SLE patients. However, an increased risk of cervical dysplasia is also associated with immunosuppressive medication exposures, particularly cyclophosphamide. For these reasons, it is important that women with SLE follow established guidelines for cervical cancer screening.

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“…Takai et al reported that, in 601 patients with hematological malignancies, the incidence of post-chemotherapy liver injury among patients with chronic HBV infection, i.e., HBV carriers, was significantly higher than that among non-carriers, suggesting that chronic hepatitis virus infection might interfere with chemotherapy and affect the outcomes of these patients 6. Another study that investigated chronic HBV infections in diffuse large B-cell lymphoma patients showed that the overall survival of carrier patients with hepatic dysfunction was significantly shorter than that of patients without liver dysfunction 7. In contrast, significant hepatic dysfunction and reactivation of the hepatitis C virus (HCV) are less common among HCV-infected patients treated with chemotherapy for hematological malignancies 3,8.…”

Section: Introductionmentioning

confidence: 99%

Chronic hepatitis virus infection in patients with multiple myeloma: clinical characteristics and outcomes

Teng

Liu

et al. 2011

Clinics

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OBJECTIVES:Cytotoxic agents and steroids are used to treat lymphoid malignancies, but these compounds may exacerbate chronic viral hepatitis. For patients with multiple myeloma, the impact of preexisting hepatitis virus infection is unclear. The aim of this study is to explore the characteristics and outcomes of myeloma patients with chronic hepatitis virus infection.METHODS:From 2003 to 2008, 155 myeloma patients were examined to determine their chronic hepatitis virus infection statuses using serologic tests for the hepatitis B (HBV) and C viruses (HCV). Clinical parameters and outcome variables were retrieved via a medical chart review.RESULTS:The estimated prevalences of chronic HBV and HCV infections were 11.0% (n = 17) and 9.0% (n = 14), respectively. The characteristics of patients who were hepatitis virus carriers and those who were not were similar. However, carrier patients had a higher prevalence of conventional cytogenetic abnormalities (64.3% vs. 25.0%). The cumulative incidences of grade 3-4 elevation of the level of alanine transaminase, 30.0% vs. 12.0%, and hyperbilirubinemia, 20.0% vs. 1.6%, were higher in carriers as well. In a Kaplan-Meier analysis, carrier patients had worse overall survival (median: 16.0 vs. 42.4 months). The prognostic value of carrier status was not statistically significant in the multivariate analysis, but an age of more than 65 years old, the presence of cytogenetic abnormalities, a beta-2-microglobulin level of more than 3.5 mg/L, and a serum creatinine level of more than 2 mg/dL were independent factors associated with poor prognosis.CONCLUSION:Myeloma patients with chronic hepatitis virus infections might be a distinct subgroup, and close monitoring of hepatic adverse events should be mandatory.

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Clinical and prognostic analysis of hepatitis B virus infection in diffuse large B-cell lymphoma

Cited by 59 publications

References 29 publications

Clinical analysis and prognostic significance of hepatitis B virus infections for diffuse large B-cell lymphoma with or without rituximab therapy

Clinical analysis and prognostic significance of hepatitis B virus infections for diffuse large B-cell lymphoma with or without rituximab therapy

Malignancy in systemic lupus erythematosus: what have we learned?

Chronic hepatitis virus infection in patients with multiple myeloma: clinical characteristics and outcomes

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