Hepatitis B virus screening in patients with non-Hodgkin lymphoma in clinical practice in Poland - a report of the Polish Lymphoma Research Group

Introduction: The risk of HBV reactivation is important in lymphoma patients receiving immunosuppressive chemotherapy containing steroids or anti-CD20 antibodies. We aimed to establish the prevalence of HBV Ag and anti-HBc serologic positive results in patients with non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL) in Poland before anti-CD20 therapy initiation; to assess the frequency of insufficient HBV screening; and to assess the association between inadequate HBV screening and diagnosis according to the WHO classification and age or gender. Material and methods: We retrospectively collected data from 805 patients with non-Hodgkin lymphoma and chronic lymphocytic leukemia treated in 2016-2018. Results: We found a positive result of HBsAg in 13 (1.16%), and a negative result in 633 (78.64%) patients. The test was not done in 159 (19.75%) patients. In the HBsAg negative subgroup of 633 patients, we found that the anti-HBc was positive in 52 (8.22%), negative in 303 (47.87%) and not done in 278 patients. In 136 out of 805 (16.9%) patients diagnostics tests were not performed before therapy initiation. We found that age is significantly associated (p = 0.0002) with the lack of HBV infection screening, and in CLL this risk is significantly (p = 0.024) higher (by 49%) compared with other WHO diagnosis subgroups. Conclusions: In Polish lymphoma patients the incidence of positive HBsAg and/or anti-HBc results is consistent with the prevalence in the United States or Australia. The adherence to appropriate HBV screening guidelines in Polish centers is not sufficient. We should intensify educational strategies in the global oncohematologic medical community.