The impact of hepatitis B virus (HBV) infection on clinical outcomes of patients with diffuse large B-cell lymphoma

Law, Man Fai; Lai, Ho Kei; Chan, Hay Nun; Ha, Chung Yin; Ng, Chi‐Fai; Yeung, Yiu Ming; Yip, Sze Fai

doi:10.1111/ecc.12166

Cited by 22 publications

(29 citation statements)

References 30 publications

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“…An earlier disease onset age in HBsAg-positive patients was reported by studies from both Korea [ 3 ] and China [ 18 , 19 , 21 ]. A more advanced stage and frequent involvement of spleen in HBsAg-positive DLBCL patients were also reported by Wang et al [ 18 ], but not by others [ 17 , 19 , 20 , 22 ]. The discrepancy might be ascribed to the small sample sizes [ 17 , 22 ], different prevalence of HBV infection, and inclusion of T-cell lymphoma which is less frequently associated with HBV infection [ 17 , 23 ].…”

Section: Discussionsupporting

confidence: 59%

Hepatitis B virus-associated diffuse large B-cell lymphoma: unique clinical features, poor outcome, and hepatitis B surface antigen-driven origin

et al. 2015

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While the epidemiologic association between hepatitis B virus (HBV) infection and diffuse large B-cell lymphoma (DLBCL) is established, little is known more than this epidemiologic evidence. We studied a cohort of 587 patients with DLBCL for HBV infection status, clinicopathologic features, and the immunoglobulin variable region in HBV surface antigen (HBsAg)-positive patients. Eighty-one (81/587, 13.8%) patients were HBsAg-positive. Compared with HBsAg-negative DLBCL, HBsAg-positive DLBCL displayed a younger median onset age (45 vs. 55 years), more frequent involvement of spleen or retroperitoneal lymph node (40.7% vs. 16.0% and 61.7% vs. 31.0% respectively, both p < 0.001), more advanced disease (stage III/IV: 76.5% vs 59.5%, p = 0.003), and significantly worse outcome (2-year overall survival: 47% versus 70%, p < 0.001). In HBsAg-positive DLBCL patients, almost all (45/47, 96%) amino acid sequences of heavy and light chain complementarity determining region 3 exhibited a high homology to antibodies specific for HBsAg, and the majority (45/50, 90%) of IgHV and IgLV genes were mutated. We conclude that 13.8% of DLBCL cases are HBV-associated in HBV-endemic China and show unique clinical features and poor outcomes. Furthermore, our study strongly suggests that HBV-associated DLBCL might arise from HBV antigen-selected B cells.

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Section: Discussionsupporting

confidence: 59%

Hepatitis B virus-associated diffuse large B-cell lymphoma: unique clinical features, poor outcome, and hepatitis B surface antigen-driven origin

et al. 2015

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“…In addition, since HBV reactivation in our patients was observed 6 months to 1 year after the cessation of chemotherapy, several studies found out that cessation of rituximab-CHOP chemotherapy and antiviral such as lumivadine resulted in delayed HBV reactivation [ 15 , 16 ]. Thus, prophylactic antiviral therapy was recommended to extend to at least one year after discontinuation of chemotherapy [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Negative effect of hepatitis in overall and progression-free survival among patients with diffuse large B-cell lymphoma

Al‐Μansour

Alghamdi

Alsubaie

et al. 2018

Infect Agents Cancer

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BackgroundHepatitis B virus (HBV) is one of the most prevalent and serious infections worldwide. HBV reactivation is a serious complication for lymphoma patients who are being treated with rituximab-containing regimen. Since the impact of HBV has not been fully evaluated on the prognosis of diffuse large B cell lymphoma (DLBCL), this study examined the effect of the hepatitis infection on the progression-free survival (PFS) and overall survival (OS) in patients with DLBCL who received rituximab-containing chemotherapy.MethodsThis retrospective cohort study was conducted at Princess Noorah Oncology Center, Jeddah by reviewing all medical records of 172 DLBCL diagnosed patients and recieved Rituximab-containing chemotherapy dated from January 2009 to February 2016.ResultsOut of 172 patients, 53 were found positive in hepatitis serology. The 12 of those were HBsAg-positive and 41 were HBcAb-positive. Hepatitis reactivation was observed in 1% of the patients (i.e., 2 out of 172) and both of them were HBsAg-positive. Thus, the risk of hepatitis reactivation among the HBsAg-positive patients was 17% (i.e., 2 out of 12). The predicted 3-year PFS for HBsAg-positive and HBcAb-positive were 52% (± 8%), while 76% (± 4) for HBsAg-negative and HBcAb-negative patients. On the other hand, the predicted 3-year OS for HBsAg and HBcAb-negative group is 93% (±3) while for HBsAg-positive and HBcAb-positive is 77% (±7), respectively.ConclusionThe present study demonstrated a low HBV reactivation rate of 1% exclusively in 2 patients with HBsAg-positive status diagnosed with DLBCL and receiving R-CHOP chemotherapy.

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“…Although there are few clinical trials to show a higher prevalence of HBsAg in DLBCL patients 6 , there have been no large analyses of HBV that report the relationship to DLBCL severity, staging, or prognosis. At present, the effect of the HBV positivity rate of serum on the prognosis of DLBCL remains unknown 7 , 8 .…”

Section: Introductionmentioning

confidence: 99%

Capable Infection of Hepatitis B Virus in Diffuse Large B-cell Lymphoma

Wang¹,

HuiJie²,

Pan³

et al. 2018

J. Cancer

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Background: Diffuse large B-cell lymphoma (DLBCL) is the most common pathological type of non-Hodgkin lymphoma (NHL). It is strongly correlated to the host immunity and infection status.Aim: This study tested the hypothesis that hepatitis B virus (HBV) infection is also associated with DLBCL.Methods: Clinical analysis of the correlation between DLBCL and HBV infection, detection of HBV in situ of DLBCL tissue, and biological experiments that determined whether HBV infects B lymphocytes were conducted.Results: Our long-term clinical data showed that the positive rate of serum HBV was significantly increased in DLBCL patients (23.6%) compared to that in the general Chinese population (7.2%, P<0.001), especially in advanced stage lymphoma patients (P=0.003). In addition, HBV could infect B lymphocytes in vitro and the HBV antigen and nucleic acid could be detected intracellularly. Hepatitis B x protein (HBx) was also strongly expressed in tissues from DLBCL patients that were serum HBV surface antigen (HBsAg) positive. These patients responded less well to therapy with an odds ratio (OR) of 3.04.Conclusions: HBV can infect B lymphocytes. It might be related to the development of DLBCL and may also impact the efficacy of treatment.

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The impact of hepatitis B virus (HBV) infection on clinical outcomes of patients with diffuse large B-cell lymphoma

Cited by 22 publications

References 30 publications

Hepatitis B virus-associated diffuse large B-cell lymphoma: unique clinical features, poor outcome, and hepatitis B surface antigen-driven origin

Hepatitis B virus-associated diffuse large B-cell lymphoma: unique clinical features, poor outcome, and hepatitis B surface antigen-driven origin

Negative effect of hepatitis in overall and progression-free survival among patients with diffuse large B-cell lymphoma

Capable Infection of Hepatitis B Virus in Diffuse Large B-cell Lymphoma

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