國家衛生研究院 NHRI:Item 3990099045/8853
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    题名: Long-term outcome of chemotherapy-induced HBV reactivation in lymphoma patients with resolved HBV infection
    作者: Yang, HC;Tsou, HH;Chuang, MH;Chen, CL;Liu, TW;Chen, PJ;Cheng, AL;Hsu, C
    贡献者: Division of Biostatistics and Bioinformatics;National Institute of Cancer Research
    摘要: Background and Aims: Hepatitis B virus (HBV) reactivation can occur to 10–40% of lymphoma patients with ‘resolved’ HBV infection (HBsAg-negative and anti-HBc-positive) who received rituximab-based chemotherapy, but its impact on survival outcome was unclear. Methods: We prospectively followed 150 newly diagnosed lymphoma patients with resolved HBV infection who receive rituximab-CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone)-based chemotherapy by regular HBV DNA monitoring. Patients withdocumented HBV reactivation, defined as a greater than 10-fold increase in HBV DNA compared with previous nadir levels, were treated with entecavir. Quantification of anti-HBc and anti-HBs levels at baseline was correlated with the risk of HBV reactivation and survival. Results: With a median follow-up of 46.0 months (range 1.1–63.9), patients who had HBV reactivation after rituximab-CHOPchemotherapy (n = 17) had worse survival than patients without(n = 133). The estimated 3-year overall survival rate was 52.3% (95% CI 50.2–54.4%) for patients with HBV reactivation and 78.2% (95% CI 72.3–84.1%) for those without (p = 0.033), and the 3-year progression-freesurvival rate was 46.3% (95% CI39.9–52.7%)vs. 72.9% (95% CI 69.6–76.3%) (p = 0.062). Thirty-eight patients died during follow-up. The major causes of death were tumor progression (18 patients), infection/sepsis (17 patients) and others(3 patients) and not significantly different between patients with or without HBV reactivation. Low anti-HBs and high anti-HBc levels at baseline predicted high risk of HBV reactivation. Conclusions: Chemotherapy-induced HBV reactivation was associated with worse survival in lymphoma patients with resolved HBV infection. Patients with low baseline anti-HBs and high anti-HBc levels may benefit most from prophylactic antiviral therapy.
    日期: 2015-04
    關聯: Journal of Hepatology. 2015 Apr;62, Suppl. 2:S563.
    Link to: http://dx.doi.org/10.1016/S0168-8278(15)30853-9
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0168-8278&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000362830600365
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