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, Jin Seok 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 SuhYok Lam Kwong, Won Seog Kim

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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

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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    Kim, S. J., Hsu, C., Song, Y. Q., Tay, K., Hong, X. N., Cao, J., Kim, J. S., Eom, H. S., Lee, J. H., Zhu, J., Chang, K. M., Reksodiputro, A. H., Tan, D., Goh, Y. T., Lee, J., Intragumtornchai, T., Chng, W. J., Cheng, A. L., Lim, S. T., ... Kim, W. S. (2013). Hepatitis B virus reactivation in B-cell lymphoma patients treated with rituximab: Analysis from the Asia Lymphoma Study Group. European Journal of Cancer, 49(16), 3486-3496. https://doi.org/10.1016/j.ejca.2013.07.006