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. Issue 8 (3rd August 2015)

• Record Type: Journal Article
• Authors: Wu, Chia-Yun; Hsiao, Liang-Tsai; Chiou, Tzeon-Jye; Gau, Jyh-Pyng; Liu, Jin-Hwang; Yu, Yuan-Bin; Wu, Yi-Tsui; Liu, Chia-Jen; Huang, Yu-Chung; Hung, Man-Hsin; Chen, Po-Min; Huang, Yi-Hsiang; Tzeng, Cheng-Hwai
• Is Part Of: Leukemia & lymphoma. Volume 56:Issue 8(2015:Aug.)
• Page Start: 2357
• Page End: 2364
• Publication Date: 2015-08-03
• Subjects: HBV reactivation -- resolved hepatitis B -- diffuse large B-cell lymphoma -- rituximab -- lymphocyte/monocyte ratio; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.3109/10428194.2014.991922
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract : 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.