Hepatitis B virus reactivation in B-cell lymphoma patients treated with rituximab

Analysis from the Asia Lymphoma Study Group

Seok Jin Kim, Chiun Hsu, Yu Qin Song, Kevin Tay, Xiao Nan Hong, Junning Cao, Jinseok Kim, Hyeon Seok Eom, Joon Hyeok Lee, Jun Zhu, Kian Meng Chang, Arry Harryanto Reksodiputro, Daryl Tan, Yeow Tee Goh, Jejung Lee, Tanin Intragumtornchai, Wee Joo Chng, Ann Lii Cheng, Soon Thye Lim, Cheolwon Suh & 2 others Yok Lam Kwong, Won Seog Kim

Research output: Contribution to journalArticle

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Abstract

Background Hepatitis B virus (HBV) reactivation is increasing, as rituximab has become widely used for B-cell lymphoma. Thus, prevention and management of HBV reactivation are important in HBV-endemic areas. Methods Hepatitis B virus (HBV) reactivation in HBV surface antigen (HBsAg)-positive patients and HBsAg-negative/HBV core antibody (HBcAb)-positive patients who received rituximab-containing chemotherapy was investigated by the Asia Lymphoma Study Group via retrospective (n = 340), and the results were compared to cross-sectional analysis with patients who were prospectively monitored in a single institute (n = 127). The goal of the study was to define the frequency of HBV reactivation and the efficacy of antiviral prophylaxis. Results HBV reactivation was found in 27.8% of HBsAg-positive patients (45/162) in the retrospective analysis, being significantly less frequent in patients receiving antiviral prophylaxis than those not (22.9%, 32/140 versus 59.1%, 13/22; p < 0.001). Lamivudine was most commonly used (96/162, 59.3%), but more than 20% of HBsAg-positive patients showed breakthrough HBV reactivation. In the cross-sectional analysis, a reduced rate of HBV reactivation occurred for entecavir as compared with lamivudine prophylaxis (6.3% versus 39.3%; p < 0.05). HBV DNA monitoring of HBsAg-negative/HBcAb-positive patients in the cross-sectional analysis showed HBV reactivation in only 2.4% of cases. Conclusions This is the largest study of HBV reactivation in patients receiving rituximab-containing chemotherapy to date, and we defined the probability of HBV reactivation in an HBV-endemic region.

Original languageEnglish
Pages (from-to)3486-3496
Number of pages11
JournalEuropean Journal of Cancer
Volume49
Issue number16
DOIs
Publication statusPublished - 2013 Nov 1

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B-Cell Lymphoma
Hepatitis B virus
Lymphoma
Surface Antigens
Lamivudine
Cross-Sectional Studies
Rituximab
Antiviral Agents
Hepatitis B Antibodies
Drug Therapy
Hepatitis B Surface Antigens

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Kim, Seok Jin ; Hsu, Chiun ; Song, Yu Qin ; Tay, Kevin ; Hong, Xiao Nan ; Cao, Junning ; Kim, Jinseok ; Eom, Hyeon Seok ; Lee, Joon Hyeok ; Zhu, Jun ; Chang, Kian Meng ; Reksodiputro, Arry Harryanto ; Tan, Daryl ; Goh, Yeow Tee ; Lee, Jejung ; Intragumtornchai, Tanin ; Chng, Wee Joo ; Cheng, Ann Lii ; Lim, Soon Thye ; Suh, Cheolwon ; Kwong, Yok Lam ; Kim, Won Seog. / Hepatitis B virus reactivation in B-cell lymphoma patients treated with rituximab : Analysis from the Asia Lymphoma Study Group. In: European Journal of Cancer. 2013 ; Vol. 49, No. 16. pp. 3486-3496.
@article{7168fbacd1c24176830bba51604a70b1,
title = "Hepatitis B virus reactivation in B-cell lymphoma patients treated with rituximab: Analysis from the Asia Lymphoma Study Group",
abstract = "Background Hepatitis B virus (HBV) reactivation is increasing, as rituximab has become widely used for B-cell lymphoma. Thus, prevention and management of HBV reactivation are important in HBV-endemic areas. Methods Hepatitis B virus (HBV) reactivation in HBV surface antigen (HBsAg)-positive patients and HBsAg-negative/HBV core antibody (HBcAb)-positive patients who received rituximab-containing chemotherapy was investigated by the Asia Lymphoma Study Group via retrospective (n = 340), and the results were compared to cross-sectional analysis with patients who were prospectively monitored in a single institute (n = 127). The goal of the study was to define the frequency of HBV reactivation and the efficacy of antiviral prophylaxis. Results HBV reactivation was found in 27.8{\%} of HBsAg-positive patients (45/162) in the retrospective analysis, being significantly less frequent in patients receiving antiviral prophylaxis than those not (22.9{\%}, 32/140 versus 59.1{\%}, 13/22; p < 0.001). Lamivudine was most commonly used (96/162, 59.3{\%}), but more than 20{\%} of HBsAg-positive patients showed breakthrough HBV reactivation. In the cross-sectional analysis, a reduced rate of HBV reactivation occurred for entecavir as compared with lamivudine prophylaxis (6.3{\%} versus 39.3{\%}; p < 0.05). HBV DNA monitoring of HBsAg-negative/HBcAb-positive patients in the cross-sectional analysis showed HBV reactivation in only 2.4{\%} of cases. Conclusions This is the largest study of HBV reactivation in patients receiving rituximab-containing chemotherapy to date, and we defined the probability of HBV reactivation in an HBV-endemic region.",
author = "Kim, {Seok Jin} and Chiun Hsu and Song, {Yu Qin} and Kevin Tay and Hong, {Xiao Nan} and Junning Cao and Jinseok Kim and Eom, {Hyeon Seok} and Lee, {Joon Hyeok} and Jun Zhu and Chang, {Kian Meng} and Reksodiputro, {Arry Harryanto} and Daryl Tan and Goh, {Yeow Tee} and Jejung Lee and Tanin Intragumtornchai and Chng, {Wee Joo} and Cheng, {Ann Lii} and Lim, {Soon Thye} and Cheolwon Suh and Kwong, {Yok Lam} and Kim, {Won Seog}",
year = "2013",
month = "11",
day = "1",
doi = "10.1016/j.ejca.2013.07.006",
language = "English",
volume = "49",
pages = "3486--3496",
journal = "European Journal of Cancer",
issn = "0959-8049",
publisher = "Elsevier Limited",
number = "16",

}

Kim, SJ, Hsu, C, Song, YQ, Tay, K, Hong, XN, Cao, J, Kim, J, Eom, HS, Lee, JH, Zhu, J, Chang, KM, Reksodiputro, AH, Tan, D, Goh, YT, Lee, J, Intragumtornchai, T, Chng, WJ, Cheng, AL, Lim, ST, Suh, C, Kwong, YL & Kim, WS 2013, 'Hepatitis B virus reactivation in B-cell lymphoma patients treated with rituximab: Analysis from the Asia Lymphoma Study Group', European Journal of Cancer, vol. 49, no. 16, pp. 3486-3496. https://doi.org/10.1016/j.ejca.2013.07.006

Hepatitis B virus reactivation in B-cell lymphoma patients treated with rituximab : Analysis from the Asia Lymphoma Study Group. / Kim, Seok Jin; Hsu, Chiun; Song, Yu Qin; Tay, Kevin; Hong, Xiao Nan; Cao, Junning; Kim, Jinseok; Eom, Hyeon Seok; Lee, Joon Hyeok; Zhu, Jun; Chang, Kian Meng; Reksodiputro, Arry Harryanto; Tan, Daryl; Goh, Yeow Tee; Lee, Jejung; Intragumtornchai, Tanin; Chng, Wee Joo; Cheng, Ann Lii; Lim, Soon Thye; Suh, Cheolwon; Kwong, Yok Lam; Kim, Won Seog.

In: European Journal of Cancer, Vol. 49, No. 16, 01.11.2013, p. 3486-3496.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hepatitis B virus reactivation in B-cell lymphoma patients treated with rituximab

T2 - Analysis from the Asia Lymphoma Study Group

AU - Kim, Seok Jin

AU - Hsu, Chiun

AU - Song, Yu Qin

AU - Tay, Kevin

AU - Hong, Xiao Nan

AU - Cao, Junning

AU - Kim, Jinseok

AU - Eom, Hyeon Seok

AU - Lee, Joon Hyeok

AU - Zhu, Jun

AU - Chang, Kian Meng

AU - Reksodiputro, Arry Harryanto

AU - Tan, Daryl

AU - Goh, Yeow Tee

AU - Lee, Jejung

AU - Intragumtornchai, Tanin

AU - Chng, Wee Joo

AU - Cheng, Ann Lii

AU - Lim, Soon Thye

AU - Suh, Cheolwon

AU - Kwong, Yok Lam

AU - Kim, Won Seog

PY - 2013/11/1

Y1 - 2013/11/1

N2 - Background Hepatitis B virus (HBV) reactivation is increasing, as rituximab has become widely used for B-cell lymphoma. Thus, prevention and management of HBV reactivation are important in HBV-endemic areas. Methods Hepatitis B virus (HBV) reactivation in HBV surface antigen (HBsAg)-positive patients and HBsAg-negative/HBV core antibody (HBcAb)-positive patients who received rituximab-containing chemotherapy was investigated by the Asia Lymphoma Study Group via retrospective (n = 340), and the results were compared to cross-sectional analysis with patients who were prospectively monitored in a single institute (n = 127). The goal of the study was to define the frequency of HBV reactivation and the efficacy of antiviral prophylaxis. Results HBV reactivation was found in 27.8% of HBsAg-positive patients (45/162) in the retrospective analysis, being significantly less frequent in patients receiving antiviral prophylaxis than those not (22.9%, 32/140 versus 59.1%, 13/22; p < 0.001). Lamivudine was most commonly used (96/162, 59.3%), but more than 20% of HBsAg-positive patients showed breakthrough HBV reactivation. In the cross-sectional analysis, a reduced rate of HBV reactivation occurred for entecavir as compared with lamivudine prophylaxis (6.3% versus 39.3%; p < 0.05). HBV DNA monitoring of HBsAg-negative/HBcAb-positive patients in the cross-sectional analysis showed HBV reactivation in only 2.4% of cases. Conclusions This is the largest study of HBV reactivation in patients receiving rituximab-containing chemotherapy to date, and we defined the probability of HBV reactivation in an HBV-endemic region.

AB - Background Hepatitis B virus (HBV) reactivation is increasing, as rituximab has become widely used for B-cell lymphoma. Thus, prevention and management of HBV reactivation are important in HBV-endemic areas. Methods Hepatitis B virus (HBV) reactivation in HBV surface antigen (HBsAg)-positive patients and HBsAg-negative/HBV core antibody (HBcAb)-positive patients who received rituximab-containing chemotherapy was investigated by the Asia Lymphoma Study Group via retrospective (n = 340), and the results were compared to cross-sectional analysis with patients who were prospectively monitored in a single institute (n = 127). The goal of the study was to define the frequency of HBV reactivation and the efficacy of antiviral prophylaxis. Results HBV reactivation was found in 27.8% of HBsAg-positive patients (45/162) in the retrospective analysis, being significantly less frequent in patients receiving antiviral prophylaxis than those not (22.9%, 32/140 versus 59.1%, 13/22; p < 0.001). Lamivudine was most commonly used (96/162, 59.3%), but more than 20% of HBsAg-positive patients showed breakthrough HBV reactivation. In the cross-sectional analysis, a reduced rate of HBV reactivation occurred for entecavir as compared with lamivudine prophylaxis (6.3% versus 39.3%; p < 0.05). HBV DNA monitoring of HBsAg-negative/HBcAb-positive patients in the cross-sectional analysis showed HBV reactivation in only 2.4% of cases. Conclusions This is the largest study of HBV reactivation in patients receiving rituximab-containing chemotherapy to date, and we defined the probability of HBV reactivation in an HBV-endemic region.

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U2 - 10.1016/j.ejca.2013.07.006

DO - 10.1016/j.ejca.2013.07.006

M3 - Article

VL - 49

SP - 3486

EP - 3496

JO - European Journal of Cancer

JF - European Journal of Cancer

SN - 0959-8049

IS - 16

ER -