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Title: Hepatitis B virus reactivation in B-cell lymphoma patients treated with rituximab: Analysis from the Asia Lymphoma Study Group
Authors: 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.
Suh, C.
Kwong, Y.-L.
Kim, W.S.
Keywords: B-cell
Hepatitis B virus
Issue Date: Nov-2013
Source: 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., Suh, C., Kwong, Y.-L., Kim, W.S. (2013-11). 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. ScholarBank@NUS Repository.
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. © 2013 Elsevier Ltd. All rights reserved.
Source Title: European Journal of Cancer
ISSN: 09598049
DOI: 10.1016/j.ejca.2013.07.006
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