Clinical Characters And Prognostic Analysis Of Diffuse Large B-Cell Lymphoma Patients With Hepatitis B Virus Infection

[Objective] To analyze the liver function in DLBCL patients with HBsAg-/HBcAb+treated with CHOP and RCHOP.[Methods] In this retrospective study,86DLBCL patients with HBsAg-/HBcAb+were collected from Cancer Institute of Chinese Academy of Medical Sciences between January2005and December2008. Patients were given at least two cycles of chemotherapy using CHOP-like or RCHOP-like regimen without anti-HBV treatment, and follow-up for at least12months after completion of therapy.[Results]47patients received CHOP-like regimen while39patients received RCHOP-like regimen. There are no significant differences in the degree of liver dysfunction between CHOP group and RCHOP group after the1st,2nd,3rd,4th and6th cycles(22.70%～46.70%with CHOP and17.60%～34.20%with R-CHOP respectively,all p>0.05),except for the5th cycles(28.60%VS6.20%, P=0.026). Most of the liver function of patients in CHOP group and RCHOP group are normal after every cycle (53.3%-77.3%and65.8%-93.8%respectively). Meanwhile, there are no significant differences in the degree of liver dysfunction between CHOP group and RCHOP group in the1st-3rd month,4th-6th month,7th-9th month and10th-12th month after completion of therapy(7.70%～40.00%with CHOP and7.40%～32.00%with R-CHOP respectively,all p>0.05).[Conclusion] The present study revealed a low incidence of liver dysfunction of DLBCL patients with HBsAg-/HBcAb+both in CHOP group and in RCHOP group, which may indicates potential low incidence of HBV reactivation in these groups and Rituximab didn’t increase the rate of liver dysfunction. Therefore, These data may not support regularly prophylactic antivirus therapy during chemotherapy but close monitoring of liver function, HBV serum markers and HBV DNA level are demanded. [Objective]Explore the relationship between Hepatitis B virus (HBV) and diffuse large B-cell lymphoma (DLBCL).[Methods] In this retrospective study,308cases of DLBCL patients were divided into three groups as HBsAg+, HBsAg-/HbcAb+and HBsAg-/HbcAb-patients. All of them were received CHOP-like or RCHOP-like chemotherapy. Various statistical analyses were used to analyze the clinical parameters and hepatic dysfunction during and after the chemotherapy between those three groups.[Results] There were31HBsAg+patients,90HBsAg-/HbcAb+patients and118HBsAg-/HbcAb-cases.3-year overall survival rate were80.9%,74.3%and84.1%respectively which shows no significant difference, and the same was progress free survival rate. Multivariate analysis by Cox regression showed that sex, age, IPI and Rituximap are related to the prognosis. The liver dysfunctions of those three groups were36.8%,27.3%and62.1%respectively during the chemotherapy. Statistical Analysis shows that liver dysfunction of HBsAg+patients was much higher than those two groups both during the chemotherapy and within3months after the chemotherapy(P=0.00039and0.008respectively).[Conclusion]There were no significant differences in clinical parameters and prognosis between. HBsAg+patients, HBsAg-/HbcAb+patients and HBsAg-/HbcAb-cases. The use of rituximab increases the OS of all case. Prophylactic treatment of HBV was suggested in the cases of HBsAg+patients and continues until3months after the treatment, during which the liver function and the level of HBV DNA should be monitored closely.