Hepatitis B Surface Antigen Positivity Is an Independent Unfavorable Prognostic Factor in Diffuse Large B-Cell Lymphoma in the Rituximab Era
| Autor: | Sheng Chuan Huang, Ming-Kai Chuang, Tung-Hung Su, Jia Hong Chen, Wei Quan Fang, Jia Hau Liu, Hwei-Fang Tien, Chang Tsu Yuan, Chao Hung Wei, Chieh-Lung Cheng |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Oncology Cancer Research HBsAg medicine.medical_specialty medicine.disease_cause 03 medical and health sciences 0302 clinical medicine Prednisone hemic and lymphatic diseases Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Letters to the Editor Cyclophosphamide Retrospective Studies Hepatitis B virus Hepatitis B Surface Antigens business.industry Cancer Retrospective cohort study medicine.disease Prognosis Lymphoma 030104 developmental biology Doxorubicin Vincristine 030220 oncology & carcinogenesis Rituximab Lymphoma Large B-Cell Diffuse business Diffuse large B-cell lymphoma medicine.drug |
| Zdroj: | Oncologist |
| ISSN: | 1549-490X |
| Popis: | Background Patients with diffuse large B-cell lymphoma (DLBCL) with concurrent hepatitis B surface antigen (HBsAg)-positive hepatitis B virus (HBV) infection have distinct clinical features. Nevertheless, the prognostic value of HBsAg in DLBCL in the rituximab era remains unclear. Materials and Methods We conducted a retrospective cohort study to investigate the clinical relevance of HBsAg in immunocompetent patients with DLBCL treated with homogeneous rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone between 2002 and 2016. Results Among 416 analyzed patients, 98 (23.6%) were HBsAg positive. HBsAg positivity was associated with a younger age and more advanced stage at diagnosis, more frequent hepatic impairment during perichemotherapy, and a trend of higher National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI) score at diagnosis. Compared with the HBsAg-negative patients, the HBsAg-positive patients had a lower overall response rate (76.5% vs. 85.5%, p = .043), poorer 5-year overall survival (OS) rate (57.2% vs. 73.5%, p < .001), and shorter 5-year progression-free survival (PFS) rate (47.2% vs. 60.7%, p = .013). Multivariate analyses showed that HBsAg positivity was an independent unfavorable prognostic indicator for OS and PFS. A scoring system incorporating HBsAg positivity, the NCCN-IPI score, and serum albumin levels proved to be useful for stratifying prognostically relevant subgroups of patients with DLBCL. Conclusion This study demonstrated that HBV infection is uniquely relevant to DLBCL. HBsAg might serve as a novel biomarker to improve clinical risk stratification of patients with DLBCL in areas with high prevalence of HBV infection. Further research investigating the etiopathogenesis of HBV infection in DLBCL is imperative. Implications for Practice A considerable disparity exists regarding the prognostic relevance of hepatitis B surface antigen (HBsAg)-positive hepatitis B virus (HBV) infection in patients with diffuse large B-cell lymphoma (DLBCL). In this large, retrospective cohort study from an area with high prevalence of HBV infection, the authors demonstrated that HBsAg was an independent unfavorable factor significantly associated with survival, highlighting its potential as a novel prognostic indicator to improve the risk stratification of patients with DLBCL in the rituximab era. |
| Databáze: | OpenAIRE |
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