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KMID : 1040620230290030794
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Clinical and Molecular Hepatology
2023 Volume.29 No. 3 p.794 ~ p.809
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Treated chronic hepatitis B is a good prognostic factor of diffuse large B-cell lymphoma
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Park Jea-Yeon
Chung Sung-Won
Lee Yun-Bin
Shin Hyun-Jae
Hur Moon-Haeng
Cho Hee-Jin
Park Min-Kyung
Yu Su-Jong
Kim Yoon-Jun
Yoon Jung-Hwan
Lee Jeong-Hoon
Youk Jeong-Hwan
Kim Tae-Min
Lee Ji-Yun
Lee Jeong-Ok
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Abstract
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Background/Aims : Chronic hepatitis B (CHB) is a risk factor for non-Hodgkin lymphoma (NHL). Our recent study suggested that antiviral treatment may reduce the incidence of NHL in CHB patients. This study compared the prognoses of hepatitis B virus (HBV)-associated diffuse large B-cell lymphoma (DLBCL) patients receiving antiviral treatment and HBV-unassociated DLBCL patients.
Methods : This study comprised 928 DLBCL patients who were treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) at two referral centers in Korea. All patients with CHB received antiviral treatment. Time-to-progression (TTP) and overall survival (OS) were the primary and secondary endpoints, respectively.
Results : Among the 928 patients in this study, 82 were hepatitis B surface antigen (HBsAg)-positive (the CHB group) and 846 were HBsAg-negative (the non-CHB group). The median follow-up time was 50.5 months (interquartile range [IQR]=25.6?69.7 months). Multivariable analyses showed longer TTP in the CHB group than the non-CHB group both before inverse probability of treatment weighting (IPTW; adjusted hazard ratio [aHR]=0.49, 95% confidence interval [CI]=0.29?0.82, P=0.007) and after IPTW (aHR=0.42, 95% CI=0.26?0.70, P<0.001). The CHB group also had a longer OS than the non-CHB group both before IPTW (HR=0.55, 95% CI=0.33?0.92, log-rank P=0.02) and after IPTW (HR=0.53, 95% CI=0.32?0.99, log-rank P=0.02). Although liver-related deaths did not occur in the non-CHB group, two deaths occurred in the CHB group due to hepatocellular carcinoma and acute liver failure, respectively.
Conclusions : Our findings indicate that HBV-associated DLBCL patients receiving antiviral treatment have significantly longer TTP and OS after R-CHOP treatment than HBV-unassociated DLBCL patients.
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KEYWORD
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Hepatitis B virus, Non-Hodgkin lymphoma, Rituximab, Chemotherapy, Antiviral agent
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