Cargando…

Hepatitis B virus reactivation and hepatitis in diffuse large B-cell lymphoma patients with resolved hepatitis B receiving rituximab-containing chemotherapy: risk factors and survival

INTRODUCTION: Hepatitis B virus (HBV) reactivation has been reported in B-cell lymphoma patients with resolved hepatitis B (hepatitis B surface antigen [HBsAg]-negative and hepatitis B core antibody [HBcAb]-positive). This study aimed to assess HBV reactivation and hepatitis occurrence in diffuse la...

Descripción completa

Detalles Bibliográficos
Autores principales: Chen, Kai-Lin, Chen, Jie, Rao, Hui-Lan, Guo, Ying, Huang, Hui-Qiang, Zhang, Liang, Shao, Jian-Yong, Lin, Tong-Yu, Jiang, Wen-Qi, Zou, De-Hui, Hu, Li-Yang, Wirian, Michael Lucas, Cai, Qing-Qing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4593350/
https://www.ncbi.nlm.nih.gov/pubmed/26058465
http://dx.doi.org/10.1186/s40880-015-0015-9
_version_ 1782393309626368000
author Chen, Kai-Lin
Chen, Jie
Rao, Hui-Lan
Guo, Ying
Huang, Hui-Qiang
Zhang, Liang
Shao, Jian-Yong
Lin, Tong-Yu
Jiang, Wen-Qi
Zou, De-Hui
Hu, Li-Yang
Wirian, Michael Lucas
Cai, Qing-Qing
author_facet Chen, Kai-Lin
Chen, Jie
Rao, Hui-Lan
Guo, Ying
Huang, Hui-Qiang
Zhang, Liang
Shao, Jian-Yong
Lin, Tong-Yu
Jiang, Wen-Qi
Zou, De-Hui
Hu, Li-Yang
Wirian, Michael Lucas
Cai, Qing-Qing
author_sort Chen, Kai-Lin
collection PubMed
description INTRODUCTION: Hepatitis B virus (HBV) reactivation has been reported in B-cell lymphoma patients with resolved hepatitis B (hepatitis B surface antigen [HBsAg]-negative and hepatitis B core antibody [HBcAb]-positive). This study aimed to assess HBV reactivation and hepatitis occurrence in diffuse large B-cell lymphoma (DLBCL) patients with resolved hepatitis B receiving rituximab-containing chemotherapy compared with HBsAg-negative/HBcAb-negative patients to identify risk factors for HBV reactivation and hepatitis occurrence and to analyze whether HBV reactivation and hepatitis affect the survival of DLBCL patients with resolved hepatitis B. METHODS: We reviewed the clinical data of 278 patients with DLBCL treated with rituximab-containing therapy between January 2004 and May 2008 at Sun Yat-sen University Cancer Center, China. Predictive factors for HBV reactivation, hepatitis development, and survival were examined by univariate analysis using the chi-square or Fisher’s exact test and by multivariate analysis using the Cox regression model. RESULTS: Among the 278 patients, 165 were HBsAg-negative. Among these 165 patients, 6 (10.9%) of 55 HBcAb-positive (resolved HBV infection) patients experienced HBV reactivation compared with none (0%) of 110 HBcAb-negative patients (P = 0.001). Patients with resolved hepatitis B had a higher hepatitis occurrence rate than HBsAg-negative/HBcAb-negative patients (21.8% vs. 8.2%, P = 0.013). HBcAb positivity and elevated baseline alanine aminotransferase (ALT) levels were independent risk factors for hepatitis. Among the 55 patients with resolved hepatitis B, patients with elevated baseline serum ALT or aspartate aminotransferase (AST) levels were more likely to develop hepatitis than those with normal serum ALT or AST levels (P = 0.037, P = 0.005, respectively). An elevated baseline AST level was an independent risk factor for hepatitis in these patients. Six patients with HBV reactivation recovered after immediate antiviral therapy, and chemotherapy was continued. HBcAb positivity, HBV reactivation, or hepatitis did not negatively affect the survival of DLBCL patients. CONCLUSIONS: DLBCL patients with resolved hepatitis B may have a higher risk of developing HBV reactivation and hepatitis than HBsAg-negative/HBcAb-negative patients. Close monitoring and prompt antiviral therapy are required in these patients.
format Online
Article
Text
id pubmed-4593350
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-45933502015-10-06 Hepatitis B virus reactivation and hepatitis in diffuse large B-cell lymphoma patients with resolved hepatitis B receiving rituximab-containing chemotherapy: risk factors and survival Chen, Kai-Lin Chen, Jie Rao, Hui-Lan Guo, Ying Huang, Hui-Qiang Zhang, Liang Shao, Jian-Yong Lin, Tong-Yu Jiang, Wen-Qi Zou, De-Hui Hu, Li-Yang Wirian, Michael Lucas Cai, Qing-Qing Chin J Cancer Original Article INTRODUCTION: Hepatitis B virus (HBV) reactivation has been reported in B-cell lymphoma patients with resolved hepatitis B (hepatitis B surface antigen [HBsAg]-negative and hepatitis B core antibody [HBcAb]-positive). This study aimed to assess HBV reactivation and hepatitis occurrence in diffuse large B-cell lymphoma (DLBCL) patients with resolved hepatitis B receiving rituximab-containing chemotherapy compared with HBsAg-negative/HBcAb-negative patients to identify risk factors for HBV reactivation and hepatitis occurrence and to analyze whether HBV reactivation and hepatitis affect the survival of DLBCL patients with resolved hepatitis B. METHODS: We reviewed the clinical data of 278 patients with DLBCL treated with rituximab-containing therapy between January 2004 and May 2008 at Sun Yat-sen University Cancer Center, China. Predictive factors for HBV reactivation, hepatitis development, and survival were examined by univariate analysis using the chi-square or Fisher’s exact test and by multivariate analysis using the Cox regression model. RESULTS: Among the 278 patients, 165 were HBsAg-negative. Among these 165 patients, 6 (10.9%) of 55 HBcAb-positive (resolved HBV infection) patients experienced HBV reactivation compared with none (0%) of 110 HBcAb-negative patients (P = 0.001). Patients with resolved hepatitis B had a higher hepatitis occurrence rate than HBsAg-negative/HBcAb-negative patients (21.8% vs. 8.2%, P = 0.013). HBcAb positivity and elevated baseline alanine aminotransferase (ALT) levels were independent risk factors for hepatitis. Among the 55 patients with resolved hepatitis B, patients with elevated baseline serum ALT or aspartate aminotransferase (AST) levels were more likely to develop hepatitis than those with normal serum ALT or AST levels (P = 0.037, P = 0.005, respectively). An elevated baseline AST level was an independent risk factor for hepatitis in these patients. Six patients with HBV reactivation recovered after immediate antiviral therapy, and chemotherapy was continued. HBcAb positivity, HBV reactivation, or hepatitis did not negatively affect the survival of DLBCL patients. CONCLUSIONS: DLBCL patients with resolved hepatitis B may have a higher risk of developing HBV reactivation and hepatitis than HBsAg-negative/HBcAb-negative patients. Close monitoring and prompt antiviral therapy are required in these patients. BioMed Central 2015-05-28 /pmc/articles/PMC4593350/ /pubmed/26058465 http://dx.doi.org/10.1186/s40880-015-0015-9 Text en © Chen et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Article
Chen, Kai-Lin
Chen, Jie
Rao, Hui-Lan
Guo, Ying
Huang, Hui-Qiang
Zhang, Liang
Shao, Jian-Yong
Lin, Tong-Yu
Jiang, Wen-Qi
Zou, De-Hui
Hu, Li-Yang
Wirian, Michael Lucas
Cai, Qing-Qing
Hepatitis B virus reactivation and hepatitis in diffuse large B-cell lymphoma patients with resolved hepatitis B receiving rituximab-containing chemotherapy: risk factors and survival
title Hepatitis B virus reactivation and hepatitis in diffuse large B-cell lymphoma patients with resolved hepatitis B receiving rituximab-containing chemotherapy: risk factors and survival
title_full Hepatitis B virus reactivation and hepatitis in diffuse large B-cell lymphoma patients with resolved hepatitis B receiving rituximab-containing chemotherapy: risk factors and survival
title_fullStr Hepatitis B virus reactivation and hepatitis in diffuse large B-cell lymphoma patients with resolved hepatitis B receiving rituximab-containing chemotherapy: risk factors and survival
title_full_unstemmed Hepatitis B virus reactivation and hepatitis in diffuse large B-cell lymphoma patients with resolved hepatitis B receiving rituximab-containing chemotherapy: risk factors and survival
title_short Hepatitis B virus reactivation and hepatitis in diffuse large B-cell lymphoma patients with resolved hepatitis B receiving rituximab-containing chemotherapy: risk factors and survival
title_sort hepatitis b virus reactivation and hepatitis in diffuse large b-cell lymphoma patients with resolved hepatitis b receiving rituximab-containing chemotherapy: risk factors and survival
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4593350/
https://www.ncbi.nlm.nih.gov/pubmed/26058465
http://dx.doi.org/10.1186/s40880-015-0015-9
work_keys_str_mv AT chenkailin hepatitisbvirusreactivationandhepatitisindiffuselargebcelllymphomapatientswithresolvedhepatitisbreceivingrituximabcontainingchemotherapyriskfactorsandsurvival
AT chenjie hepatitisbvirusreactivationandhepatitisindiffuselargebcelllymphomapatientswithresolvedhepatitisbreceivingrituximabcontainingchemotherapyriskfactorsandsurvival
AT raohuilan hepatitisbvirusreactivationandhepatitisindiffuselargebcelllymphomapatientswithresolvedhepatitisbreceivingrituximabcontainingchemotherapyriskfactorsandsurvival
AT guoying hepatitisbvirusreactivationandhepatitisindiffuselargebcelllymphomapatientswithresolvedhepatitisbreceivingrituximabcontainingchemotherapyriskfactorsandsurvival
AT huanghuiqiang hepatitisbvirusreactivationandhepatitisindiffuselargebcelllymphomapatientswithresolvedhepatitisbreceivingrituximabcontainingchemotherapyriskfactorsandsurvival
AT zhangliang hepatitisbvirusreactivationandhepatitisindiffuselargebcelllymphomapatientswithresolvedhepatitisbreceivingrituximabcontainingchemotherapyriskfactorsandsurvival
AT shaojianyong hepatitisbvirusreactivationandhepatitisindiffuselargebcelllymphomapatientswithresolvedhepatitisbreceivingrituximabcontainingchemotherapyriskfactorsandsurvival
AT lintongyu hepatitisbvirusreactivationandhepatitisindiffuselargebcelllymphomapatientswithresolvedhepatitisbreceivingrituximabcontainingchemotherapyriskfactorsandsurvival
AT jiangwenqi hepatitisbvirusreactivationandhepatitisindiffuselargebcelllymphomapatientswithresolvedhepatitisbreceivingrituximabcontainingchemotherapyriskfactorsandsurvival
AT zoudehui hepatitisbvirusreactivationandhepatitisindiffuselargebcelllymphomapatientswithresolvedhepatitisbreceivingrituximabcontainingchemotherapyriskfactorsandsurvival
AT huliyang hepatitisbvirusreactivationandhepatitisindiffuselargebcelllymphomapatientswithresolvedhepatitisbreceivingrituximabcontainingchemotherapyriskfactorsandsurvival
AT wirianmichaellucas hepatitisbvirusreactivationandhepatitisindiffuselargebcelllymphomapatientswithresolvedhepatitisbreceivingrituximabcontainingchemotherapyriskfactorsandsurvival
AT caiqingqing hepatitisbvirusreactivationandhepatitisindiffuselargebcelllymphomapatientswithresolvedhepatitisbreceivingrituximabcontainingchemotherapyriskfactorsandsurvival