The Association Of Hepatitis B Virus Infection With Lymphoma

Objective:This study was to investigate the prevalence of hepatitis B virus(HBV) in lymphoma;to analyze the relationship between the clinical features ofseveral common non-Hodgkin’s lymphoma subtypes with HBV infection andwhat happening of the liver dysfunction during the chemotherapy. Discuss HBVinfection of the liver dysfunction occurred in the process of chemotherapy andthe influence of HBV reactivation.Methods: A retrospective study was done about the920cases oflymphoma patients who have records of the hepatitis B surface antigen (HBsAg),hepatitis B surface antibody (HBsAb), hepatitis B e antigen (HBeAg), hepatitisB e antibody (HBeAb), hepatitis B core antibody (HBcAb); and analyzed diffuselarge B cell lymphoma (DLBCL), follicular lymphoma (FL), Peripheral T-celllymphoma (PTCL), NK/T cell lymphoma in patients with HBV infection,general clinical characteristics, liver dysfunction and HBV reactivation duringchemotherapy. Follow-up study was preceded via phone to achieve data forsurvival status.Result:1.Among all cases studied, there was a higher prevalence of HBVinfection in patients with non-Hodgkin’s lymphoma (NHL)(18.14%) than inpatients with Hodgkin’s lymphoma (HL)(7.3%); the difference was statistically significant (P=0.006).2.The ratio of the petients with “HBsAg positive, HBeAgpositive and HBcAb positive” was11.5%higher than the ratio of the patientswith “HBsAg positive, HBeAb positive and HBcAb positive”(5.1%) and the“only HBsAg positive”(1.6%).3.There was a higher prevalence of HBVinfection in patients with the B-cell subtype of NHL (20.34%) than in patientswith T-cell subtype of NHL (13.7%); the difference was statistically significant(P=0.018).4.Among the B cell sources of non-hodgkin’s lymphoma, Theinvasive NHL patients with HBsAg positive rate (20.9%) was higher thanpatients with aggressive NHL (18.6%), but there was no statistically significantdifference (P=0.630).5.Compared with the HBsAg negative group, the patientswith DLBCL HBsAg positive group displayed less than or equal to60years,more advanced stage at grade Ⅲ~Ⅳ and liver dysfunction before chemotherapy,spleen involvement; the difference was statistically significant. However twogroups of patients in the gender, lactate dehydrogenase, extra node involvement,ECOG score, liver involvement, the recent curative effect, IPI score had nosignificant difference. The overall survival（OS）and progress free survival（PFS） of two groups in patients with DLBCL were no statistical difference (Pvalues were0.296,0.280).6.In the FL， HBsAg positive group had asignificantly higher proportion of liver dysfunction before chemotherapy thanHBsAg negative group, While two groups of patients in the gender, age, lactatedehydrogenase, extra node involvement, ECOG score, clinnical stage, liver andspleen involvement, the recent curative effect, IPI score had no significantdifference.7.But in the PTCL, NK/T cell lymphoma, there had no obviousdifference with clinical characteristics between of the two groups.8.In HBsAg-positive DLBCL group, there was a higher incidence of liver dysfunction in thepatients who accepting chemotherapy only (37.0%) than the patients who accepting rituximb-containing chemotherapy regimen(18.8%),but the differencewas no statistically significant(P>0.05). Only1case occurred in patients withHBV reactivation.While in HBsAg-negative DLBCL group, there was nostatistically significant difference of the incidence of liver dysfunction betweenthe patients with chemotherapy and whose undergoing rituximb-containingchemotherapy regimen(8.5%vs9.4%).9.Patients with chemotherapy in PTCL,the HBsAg positive group had an higher incidence of hepatitis (15.4%) than thenegative group (12%), but there was no statistically significant difference (P=0.510). There was no patient occurred with HBV reactivation in the HBsAgpositive group.10. in the NK/T cell lymphoma, the HBsAg positive group hadan higher incidence of hepatitis liver dysfunction (42.9%) than the negativegroup (5.3%), and the difference was statistically significant（P=0.014）.Whilethere was no patient occurred with HBV reactivation in the HBsAg positivegroup.Conclusion:1. There was a higher prevalence of HBV infection in patientswith NHL than in patients with HL.2.In NHL, There was a higher prevalence ofHBV infection in patients with the source of B cell lymphoma than the source ofT cell lymphoma patients, prompting that more closely relationship betweenHBV infection with B cell sources of lymphoma.3. the patients with DLBCL,aged under60years, advanced stage at grade Ⅲ~Ⅳ andliver dysfunction,spleen infringement was more common in patients with HBV infection. To thepatients with DLBCL merger of HBV infection, the PFS and OS had no obviousdifference compared with patients without HBV infection, reminding that HBVinfection may not significantly affecting the survival of patients with DLBCL.4.In FL the patients with HBV infection were easy to merge the liver dysfunction; while there was no correlation between HBV infection with clinical features ofthe PTCL, NK/T cell lymphoma.