HBV activation after RCHOP-like immunochemotherapy in diffuse large B cell lymphoma patients:a retrospective multicenter study

Objective:To determine and compare the incidence of hepatitis B virus(HBV) activation in both hepatitis B surface antigen(HBsAg)-positive and HBsAg-negative patients who were diagnosed of diffuse large B cell lymphoma(DLBCL)and received rituximab-CHOP(RCHOP)-like immunochemotherapy and estimate the value of preventive anti-virus therapy.Methods:We retrospectively analyzed the clinical data from DLBCL patients who received RCHOP-like regimen in six grade 3 hospitals in Shanghai.The clinical characteristics of these patients and its correlation with HBV activation were analyzed.Results:A total of 234 patients including 29 HBsAg-positive patients and 205 HBsAg-negative patients fitted the inclusion criteria and were recruited in this study.Among the 29 HBsAg positive patients,11 received prophylactic antiviral therapy and none of them developed HBV reactivation;and in another 18 patients who did not receive antiviral prophylactic therapy,7(38.9%) cases developed HBV reactivation.Furthermore,3 out of the 7 patients who developed HBV reactivation died of liver failure.The incidence of HBV reactivation in non-prophylactic HBsAg-positive patients was significantly higher than that in the prophylactic patients(P=0.026).There was only 1 of the HBsAg-negative patients developed HBV reactivation and the incidence of HBV reactivation in HBsAg-negative patients was significantly lower than that in the HBsAg-positive ones(P=0.000).Conclusion:The present study revealed a high incidence and a bad prognosis of HBV reactivation in HBsAg-positive DLBCL patients after RCHOP-like therapy.Prophylactic antiviral therapy effectively reduced the risk of HBV reactivation in these patients.The incidence of HBV activation in HBsAg-negative DLBCL patients was relatively low and the role of antiviral prophylaxis in this population deserves further investigation.