- 作者：Seok Jin Kim ; Chiun Hsu ; Yu-Qin Song ; Kevin Tay ; Xiao-Nan Hong ; Junning Cao ; Jin Seok Kim ; Hyeon Seok Eom ; Joon Hyeok Lee ; Jun Zhu ; Kian-Meng Chang ; Arry Harryanto Reksodiputro ; Daryl Tan ; Yeow Tee Goh ; Jejung Lee ; Tanin Intragumtornchai ; Wee-Joo Chng ; Ann-Lii Cheng ; Soon Thye Lim ; Cheolwon Suh ; et al.
- 关键词：Hepatitis B virus ; Rituximab ; B-cell ; Lymphoma
- 刊名：European Journal of Cancer
- 出版年：2013
- 出版时间：November, 2013
- 年：2013
- 卷：49
- 期：16
- 页码：3486-3496
- 全文大小：431 K
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.