Diffuse large B-cell lymphoma with concurrent hepatitis B virus infection in the MabThera era: Unique clinical features and worse outcomes

Xiao Yan, Miao Zhou, Zhongze Lou, Qitian Mu, Lixia Sheng, Ping Zhang, Yi Wang, Guifang Ouyang

Journal of Cancer Research and Therapeutics 2018 14(8):248-253

Aim of Study: Hepatitis B virus (HBV) infection is a risk factor in diffuse large B-cell lymphoma (DLBCL); however, little is known other than the prevalence evidence. In addition, the impact of HBV infection to DLBCL remains controversial. The purpose of this study was to investigate the HBV infection status of 136 patients with DLBCL, analyze the clinical property of HBV-infected patients, and determine the effects of HBV infection to the outcomes of DLBCL patients. Materials and Methods: A retrospective analysis was performed in our center from January 2007 to December 2014. A total of 136 DLBCL patients accepting three or more cycles of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) or rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) regimen were analyzed. Results: Of the 136 patients, 55 were HBV-infected and their clinical features were different in several aspects such as young onset age (P = 0.027), frequent occurrence of B symptom (P = 0.009), and advanced disease stage (Stage III/IV, P = 0.037). Besides more HBV-infected patients exhibited lower levels of peripheral lymphocyte-to-monocyte ratio (≤2.0). In the survival assessment, HBV-infected patients were worse in both progression-free survival (PFS) (P = 0.001) and overall survival (OS) (P = 0.030) in MabThera treated group, but get a draw in CHOP regimen group (P = 0.658 in PFS and P = 0.798 in OS). Sort of surprisingly, HBV-infected patients treated with MabThera did not have a superior to the traditional regimen in both PFS (P = 0.969) and OS (P = 0.875). Conclusion: DLBCL patients with HBV infection are subset with unique clinical characters and have worse outcomes. The benefit of MabThera to HBV-infected DLBCL patients was uncertain thus have to be weighed against the costs before application.

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