Clinical analysis and prognostic significance of hepatitis B virus infections for diffuse large B-cell lymphoma with or without rituximab therapy

Xie,Wanzhuo; Zhou,De; Hu,Keyue; Xiao,Xibin; Huang,Weijia; He,Jinsong; Shi,Jimin; Luo,Yi; Zhang,Jie; Lin,Maofang; Cai,Zhen; Huang,He; Ye,Xiujin

doi:10.3892/etm.2013.1079

Clinical analysis and prognostic significance of hepatitis B virus infections for diffuse large B-cell lymphoma with or without rituximab therapy

Authors:
- Wanzhuo Xie
- De Zhou
- Keyue Hu
- Xibin Xiao
- Weijia Huang
- Jinsong He
- Jimin Shi
- Yi Luo
- Jie Zhang
- Maofang Lin
- Zhen Cai
- He Huang
- Xiujin Ye
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Affiliations: Department of Hematology, Bone Marrow Transplant Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, P.R. China, Department of Hematology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
Published online on: April 25, 2013 https://doi.org/10.3892/etm.2013.1079
Pages: 109-114

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Abstract

The aim of this study was to analyze the clinical features of hepatitis B surface antigen (HBsAg)-positive and negative diffuse large B-cell lymphomas (DLBCLs) and to compare the outcomes and serum hepatitis B virus (HBV)-DNA loads of patients treated with cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) regimens with rituximab (RCHOP) or without. A total of 451 DLBCL patients, of which 90 were HBsAg‑positive and 361 were HBsAg-negative, were retrospectively reviewed. We compared onset age, gender, Ann Arbor stage, international prognostic index (IPI), lactate dehydrogenase (LDH) and β2-microglobulin (β2-M) levels, as well as overall survival (OS) rates and HBV-DNA loads under CHOP or RCHOP regimens. The OS rate of the HBsAg‑positive DLBCL patients was significantly lower than that of HBsAg-negative DLBCL patients and the HBsAg‑positive DLBCL patients had an earlier median onset age. HBsAg-positive DLBCL patients had poorer OS rates compared with HBsAg-negative patients (62.2% HBsAg‑positive vs. 76.2% HBsAg-negative, P=0.018). HBsAg-positive DLBCL patients with HBV-DNA loads >103 cps/ml during chemotherapy had significantly lower OS rates than those with lower HBV-DNA loads (48.4% HBV-DNA elevated vs. 71.2% HBV-DNA normal, P=0.037). HBsAg-positive DLBCL patients treated with RCHOP had a significantly higher OS rate (79.6%) compared with the 41 CHOP-treated patients (43.9%; P<0.001). HBsAg-positive DLBCL patients with an earlier median onset age and elevated HBV-DNA during chemotherapy had poorer prognoses. HBsAg and HBV-DNA during chemotherapy may be used as prognostic indicators for patients with DLBCL. Rituximab improves the outcome of HBsAg-positive DLBCL patients when administered in combination with anti-viral lamivudine.

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