Lymphocyte/monocyte ratio and cycles of rituximab-containing therapy are risk factors for hepatitis B virus reactivation in patients with diffuse large B-cell lymphoma and resolved hepatitis B

被引:10
|
作者
Wu, Chia-Yun [1 ,5 ]
Hsiao, Liang-Tsai [1 ,5 ]
Chiou, Tzeon-Jye [1 ,2 ,5 ]
Gau, Jyh-Pyng [1 ,5 ]
Liu, Jin-Hwang [1 ,5 ]
Yu, Yuan-Bin [1 ,5 ]
Wu, Yi-Tsui [4 ]
Liu, Chia-Jen [1 ,5 ]
Huang, Yu-Chung [1 ,5 ,6 ]
Hung, Man-Hsin [1 ,5 ]
Chen, Po-Min [1 ,5 ]
Huang, Yi-Hsiang [3 ,5 ]
Tzeng, Cheng-Hwai [1 ,5 ]
机构
[1] Taipei Vet Gen Hosp, Div Hematol & Oncol, Dept Med, 201,Sec 2,Shipai Rd, Taipei 112, Taiwan
[2] Taipei Vet Gen Hosp, Dept Med, Div Transfus Med, Taipei 112, Taiwan
[3] Taipei Vet Gen Hosp, Dept Med, Div Gastroenterol, Taipei 112, Taiwan
[4] Taipei Vet Gen Hosp, Dept Nursing, Taipei 112, Taiwan
[5] Natl Yang Ming Univ, Inst Clin Med, Taipei 112, Taiwan
[6] Taipei Vet Gen Hosp, Taoyuan Branch, Dept Med, Div Hematol & Med Oncol, Taoyuan, Taiwan
关键词
HBV reactivation; resolved hepatitis B; diffuse large B-cell lymphoma; rituximab; lymphocyte/monocyte ratio; RANDOMIZED CONTROLLED-TRIAL; ANTIVIRAL PROPHYLAXIS; MALIGNANT-LYMPHOMA; HBV REACTIVATION; ELDERLY-PATIENTS; CHEMOTHERAPY; INFECTION; HBSAG; ENTECAVIR; ANTIGEN;
D O I
10.3109/10428194.2014.991922
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Reactivation of hepatitis B virus (HBV) following rituximab (R)-containing chemotherapy for lymphoma is a major concern, and risk factors remain to be defined. We enrolled 190 patients diagnosed with diffuse large B-cell lymphoma (DLBCL) and resolved hepatitis B, receiving first-line R-CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone)-based regimens. Twenty-seven patients (14.2%) developed HBV reactivation during a median follow-up of 23.6 months. Two independent risk factors were identified: cycles of rituximab > 8 (hazard ratio [HR], 2.797; 95% confidence interval [CI], 1.184-6.612) and lymphocyte/monocyte ratio (LMR) < 2.50 (HR, 2.733; 95% CI, 1.122-6.657). Two-year overall survival in patients with or without HBV reactivation was 53.8% vs. 77.6% (p = 0.025). Regarding the negative impact on clinical outcome, patients at super high risk of HBV reactivation, including those receiving more than eight cycles of R and having low LMR at diagnosis, may warrant first priority for antiviral prophylaxis.
引用
收藏
页码:2357 / 2364
页数:8
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