Awareness of hepatitis B virus reactivation among physicians authorized to prescribe chemotherapy

Turker, Kamuran; Öksüzoğlu, Berna; Balcı, Elçin; Üyetürk, Ümmügül; Hascuhadar, Medine

doi:10.1016/j.ejim.2013.07.008

Cited by 9 publications

(4 citation statements)

References 8 publications

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“…[ 5 6 7 8 9 10 ] Reactivation of HBV is a well-established complication of R-chemo and can result in hepatic mortality and interruptions in chemotherapy. [ 11 12 ]…”

Section: Introductionmentioning

confidence: 99%

Three-year Follow-up on the Safety and Effectiveness of Rituximab Plus Chemotherapy as First-Line Treatment of Diffuse Large B-Cell Lymphoma and Follicular Lymphoma in Real-World Clinical Settings in China

Song

Zhang

et al. 2018

Chinese Medical Journal

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Background:Prospective real-life data on the safety and effectiveness of rituximab in Chinese patients with diffuse large B-cell lymphoma (DLBCL) or follicular lymphoma (FL) are limited. This real-world study aimed to evaluate long-term safety and effectiveness outcomes of rituximab plus chemotherapy (R-chemo) as first-line treatment in Chinese patients with DLBCL or FL. Hepatitis B virus (HBV) reactivation management was also investigated.Methods:A prospective, multicenter, single-arm, noninterventional study of previously untreated CD20-positive DLBCL or FL patients receiving first-line R-chemo treatment at 24 centers in China was conducted between January 17, 2011 and October 31, 2016. Enrolled patients underwent safety and effectiveness assessments after the last rituximab dose and were followed up for 3 years. Effectiveness endpoints included progression-free survival (PFS) and overall survival (OS). Safety endpoints were adverse events (AEs), serious AEs, drug-related AEs, and AEs of special interest. We also reported data on the incidence of HBV reactivation.Results:In total, 283 previously untreated CD20-positive DLBCL and 31 FL patients from 24 centers were enrolled. Three-year PFS was 59% (95% confidence interval [CI]: 50–67%) for DLBCL patients and 46% (95% CI: 20–69%) for FL patients. For DLBCL patients, multivariate analyses showed that PFS was not associated with international prognostic index, tumor maximum diameter, HBV infection status, or number of rituximab treatment cycles, and OS was only associated with age >60 years (P < 0.05). R-chemo was well tolerated. The incidence of HBV reactivation in hepatitis B surface antigen (HBsAg)-positive and HBsAg-negative/hepatitis B core antibody-positive patients was 13% (3/24) and 4% (3/69), respectively.Conclusions:R-chemo is effective and safe in real-world clinical practice as first-line treatment for DLBCL and FL in China, and that HBV reactivation during R-chemo is manageable with preventive measures and treatment.Trial Registration:ClinicalTrials.gov, NCT01340443; https://clinicaltrials.gov/ct2/show/NCT01340443.

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“…[ 5 6 7 8 9 10 ] Reactivation of HBV is a well-established complication of R-chemo and can result in hepatic mortality and interruptions in chemotherapy. [ 11 12 ]…”

Section: Introductionmentioning

confidence: 99%

Three-year Follow-up on the Safety and Effectiveness of Rituximab Plus Chemotherapy as First-Line Treatment of Diffuse Large B-Cell Lymphoma and Follicular Lymphoma in Real-World Clinical Settings in China

Song

Zhang

et al. 2018

Chinese Medical Journal

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“…HBV reactivation may increase hepatic mortality and lead to interruption of curative chemotherapy, which has a deleterious impact on survival outcomes. Despite its clinical importance and urgency, awareness, attitudes, and current screening practices and preventive measures for HBV reactivation among physicians remain suboptimal [ 18 , 19 ]. A recent study in China reported HBV reactivation in approximately 17.1 % of HBsAg-positive (pos) patients receiving R-chemo [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Rituximab plus chemotherapy as first-line treatment in Chinese patients with diffuse large B-cell lymphoma in routine practice: a prospective, multicentre, non-interventional study

Song

et al. 2016

BMC Cancer

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BackgroundThe efficacy and safety of rituximab-based chemotherapy (R-chemo), the standard regimen for patients with diffuse large B-cell lymphoma (DLBCL), which is more common in Asia than in Western countries, are well confirmed in randomized controlled trials (RCTs). However, the safety and effectiveness of R-chemo in patients who are largely excluded from RCTs have not been well characterized. This real-world study investigated the safety and effectiveness of R-chemo as first-line treatment in Chinese patients with DLBCL.MethodsTreatment-naive DLBCL patients who were CD20 positive and eligible to receive R-chemo were enrolled with no specific exclusion criteria. Data collected at baseline included age, gender, disease stage, international prognostic index (IPI), B symptoms, extranodal involvement, performance status, and medical history. In the present study, data on safety, treatment effectiveness, and HBV infection management were collected 120 days after the last R-chemo administration.ResultsOverall, R-chemo was well tolerated. The safety profile of R-chemo in patients with a history of heart or liver disease was well described without any additional unexpected safety concerns. The overall response rate (ORR) in the Chinese patients from this study was 94.2 % (complete response [CR], 55.0 %; CR unconfirmed [CRu] 18.2 %; and partial response [PR], 20.9 %). Compared to patients with no history of disease, the CR and PR rates of patients with a history of heart or liver disease were lower and higher, respectively; this tendency could be in part explained by treatment interruptions in patients with heart or liver diseases. HBsAg positivity and a maximum tumor diameter of ≥7.5 cm negatively correlated with CR + CRu, whereas age and HBsAg positivity negatively correlated with CR.ConclusionsThis study further validated the safety and effectiveness of R-chemo in Chinese patients with DLBCL. Patients with a history of heart or liver disease may further benefit from R-chemo if preventive measures are taken to reduce hepatic and cardiovascular toxicity. In addition to IPI and tumor diameter, HBsAg positivity could also be a poor prognostic factor for CR in Chinese patients with DLBCL.Trial registrationClinicalTrials.gov #NCT01340443, April 20, 2011.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2523-7) contains supplementary material, which is available to authorized users.

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“…Bu çalışmada HBV reaktivasyonu açısından yüksek risk oluşturan rituksimab tedavisi öncesinde ise hastaların %69'unda HBV taraması yapıldığı bildirilmiştir (10). Kemoterapi alacak hastalarda HBV reaktivasyonu riski konusunda, hekimler arasında farkındalığın araştırıldığı bir çalışmada, kemoterapi veren hekimlerin sadece %59'unun tedavi öncesinde HBV taraması yaptığı bildirilmektedir (33). Bu nedenle kemoterapi öncesi HBV taramasının öneminin vurgulanması ve seronegatif olan hastaların da aşılanabilmesi için, hastanelerde disiplinler arası bilgilendirme toplantıları ve tarama protokollerinin oluşturulması önemli görünmektedir.…”

Section: İrdelemeunclassified

Investigation of Hepatitis B Serology in Oncological Patients Receiving Chemotherapy

Türkoğlu¹,

Uysal²,

Demirtürk³

2020

Klimik Dergisi

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Objective: In this study, we evaluated whether HBV serology had been investigated before chemotherapy or not, and whether antiviral prophylaxis had been given or not to hepatitis B surface antigen (HBsAg)-and/or hepatitis B core antibody (anti-HBc IgG)-positive patients. Methods: The study was planned retrospectively between May 2012 and April 2014. Patients who were followed in the oncology outpatient clinic and whose chemotherapy was initiated due to solid organ malignancy were included. IBM SPSS Statistics for Windows. Version 22.0 (Statistical Package for the Social Sciences, IBM Corp., Armonk, NY, USA) program was used for statistical evaluation. Results: As a result of the study, the data of 1476 regular follow-up patients were reached. 49.4% of the patients were male. The mean age was calculated as 60.6±13.3. Of the patients, 864 (58.1%) were screened for HBV infection. For screening, HBsAg and anti-HBs were used together in 53.8% of the patients, and only HBsAg was used in 4.3% of them. Anti-HBc IgG was not used in any of the patients. HBsAg positivity was 3.5% and anti-HBs positivity was 37.9% of the screened patients. Of HBsAgpositive patients, 74.1% was started prophylactic antivirals (entecavir in 2 patients, lamivudine in 21 patients), whereas eight patients did not receive prophylaxis. Conclusions: It was determined that HBV serology was investigated in most of the patients who would receive chemotherapy but the serologic parameters used for investigation were not suitable in most cases. Further studies are needed to increase awareness on this issue.

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Awareness of hepatitis B virus reactivation among physicians authorized to prescribe chemotherapy

Cited by 9 publications

References 8 publications

Three-year Follow-up on the Safety and Effectiveness of Rituximab Plus Chemotherapy as First-Line Treatment of Diffuse Large B-Cell Lymphoma and Follicular Lymphoma in Real-World Clinical Settings in China

Three-year Follow-up on the Safety and Effectiveness of Rituximab Plus Chemotherapy as First-Line Treatment of Diffuse Large B-Cell Lymphoma and Follicular Lymphoma in Real-World Clinical Settings in China

Rituximab plus chemotherapy as first-line treatment in Chinese patients with diffuse large B-cell lymphoma in routine practice: a prospective, multicentre, non-interventional study

Investigation of Hepatitis B Serology in Oncological Patients Receiving Chemotherapy

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