Hepatitis B virus reactivation in B-cell lymphoma patients treated with rituximab: Analysis from the Asia Lymphoma Study Group
Journal
European Journal of Cancer
Journal Volume
49
Journal Issue
16
Pages
3486-3496
Date Issued
2013
Author(s)
Kim S.J.
Song Y.-Q.
Tay K.
Hong X.-N.
Cao J.
Kim J.S.
Eom H.S.
Lee J.H.
Zhu J.
Chang K.-M.
Reksodiputro A.H.
Tan D.
Goh Y.T.
Lee J.
Intragumtornchai T.
Chng W.-J.
Lim S.T.
Suh C.
Kwong Y.-L.
Kim W.S.
Abstract
Background Hepatitis B virus (HBV) reactivation is increasing, as rituximab has become widely used for B-cell lymphoma. Thus, prevention and management of HBV reactivation are important in HBV-endemic areas. Methods Hepatitis B virus (HBV) reactivation in HBV surface antigen (HBsAg)-positive patients and HBsAg-negative/HBV core antibody (HBcAb)-positive patients who received rituximab-containing chemotherapy was investigated by the Asia Lymphoma Study Group via retrospective (n = 340), and the results were compared to cross-sectional analysis with patients who were prospectively monitored in a single institute (n = 127). The goal of the study was to define the frequency of HBV reactivation and the efficacy of antiviral prophylaxis. Results HBV reactivation was found in 27.8% of HBsAg-positive patients (45/162) in the retrospective analysis, being significantly less frequent in patients receiving antiviral prophylaxis than those not (22.9%, 32/140 versus 59.1%, 13/22; p < 0.001). Lamivudine was most commonly used (96/162, 59.3%), but more than 20% of HBsAg-positive patients showed breakthrough HBV reactivation. In the cross-sectional analysis, a reduced rate of HBV reactivation occurred for entecavir as compared with lamivudine prophylaxis (6.3% versus 39.3%; p < 0.05). HBV DNA monitoring of HBsAg-negative/HBcAb-positive patients in the cross-sectional analysis showed HBV reactivation in only 2.4% of cases. Conclusions This is the largest study of HBV reactivation in patients receiving rituximab-containing chemotherapy to date, and we defined the probability of HBV reactivation in an HBV-endemic region. ? 2013 Elsevier Ltd. All rights reserved.
SDGs
Other Subjects
adefovir; clevudine; corticosteroid; cyclophosphamide; doxorubicin; entecavir; hepatitis B core antibody; hepatitis B surface antigen; lamivudine; prednisone; rituximab; telbivudine; tenofovir; vincristine; virus DNA; adult; antiviral therapy; article; B cell lymphoma; chemotherapy; cross-sectional study; drug efficacy; female; hepatitis B; Hepatitis B virus; human; large cell lymphoma; major clinical study; male; priority journal; prophylaxis; retrospective study; risk factor; treatment duration; virus reactivation; B-cell; Hepatitis B virus; Lymphoma; Rituximab; Antibodies, Monoclonal, Murine-Derived; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Antiviral Agents; Asia; Biological Markers; Cross-Sectional Studies; DNA, Viral; Endemic Diseases; Female; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis B virus; Humans; Incidence; Kaplan-Meier Estimate; Lymphoma, B-Cell; Male; Middle Aged; Prospective Studies; Retrospective Studies; Treatment Outcome; Viral Load; Virus Activation
Type
journal article