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

Abstract

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.

The association of the hepatitis B virus infection and diffuse large B-cell lymphoma

“… 16 In addition, a study that collected data from 128 patients with HBsAg(+) with DLBCL, all of whom received immunochemotherapy and prophylactic antiviral therapy, found that the prognosis for HBsAg(+) patients was no worse than that for DLBCL patients. 17 Another study showed that approximately 50% of DLBCL patients receiving R-CHOP or CHOP-like chemotherapy had their therapeutic dose reduced due to active HBV infection, while 66.7% had to abandon first-line therapy due to HBV infection. 18 Therefore, in order to improve patient prognoses, early preventive intervention with antiviral drugs should be used for HBV-positive patients with relapsed refractory DLBCL.…”