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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 Suh  ;  Yok-Lam Kwong  ;  Won Seog Kim 
 EUROPEAN JOURNAL OF CANCER, Vol.49(16) : 3486-3496, 2013 
Journal Title
Issue Date
Antibodies, Monoclonal, Murine-Derived/adverse effects ; Antineoplastic Agents/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Antiviral Agents/therapeutic use ; Asia/epidemiology ; Biomarkers/blood ; Cross-Sectional Studies ; DNA, Viral/blood ; Endemic Diseases ; Female ; Hepatitis B/blood ; Hepatitis B/diagnosis ; Hepatitis B/epidemiology ; Hepatitis B/prevention & control ; Hepatitis B Surface Antigens/blood ; Hepatitis B virus/drug effects ; Hepatitis B virus/genetics ; Hepatitis B virus/immunology ; Hepatitis B virus/physiology ; Humans ; Incidence ; Kaplan-Meier Estimate ; Lymphoma, B-Cell/drug therapy ; Lymphoma, B-Cell/epidemiology ; Male ; Middle Aged ; Prospective Studies ; Retrospective Studies ; Rituximab ; Treatment Outcome ; Viral Load ; Virus Activation/drug effects
B-cell ; Hepatitis B virus ; Lymphoma ; Rituximab
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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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
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