Lim Soon-Thye, Fei Gao, Quek Richard, Lim Lay-Cheng, Lee Lai-Heng, Yap Swee-Peng, Loong Susan, Tao Miriam
Department of Medical Oncology, National Cancer Centre, Singapore.
Eur J Haematol. 2007 Aug;79(2):132-7. doi: 10.1111/j.1600-0609.2007.00878.x.
This study aims to evaluate the association between hepatitis B virus (HBV) and lymphoma and to characterize HBV-related lymphomas. The efficacy of prophylactic lamivudine on HBV reactivation was also evaluated.
We compared the prevalence rate of HBV infection in 556 patients with lymphoma seen over a 4-yr period with that in a group of 4698 Singapore residents aged 18-69 who participated in the National Health Survey. Next, we compared the clinic-pathologic characteristics of HBV-positive and HBV-negative lymphoma cases.
The prevalence rate of HBV infection in our study was 10.3% (57/556), higher than the prevalence rate of 4.1% (192/4698) in the general population (P < or = 0.001). The higher prevalence was observed in both sexes and across different age groups. An association was observed for non-Hodgkin's lymphoma (NHL) but not Hodgkin's lymphoma. The characteristics of HBV-infected patients with lymphoma were similar to those who were HBV-uninfected in terms of age, ECOG, extra-nodal involvement, LDH level, stage, complete remission rate and overall survival. Use of prophylactic lamivudine significantly decreased the incidence of HBV reactivation (13% vs. 38%, P = 0.02) and disruption to chemotherapy (43% vs. 4%, P = 0.02), with a trend towards improved overall survival.
Our findings suggest that an association exists between HBV infection and NHL. However, HBV infection does not appear to have a significant impact on the clinical characteristics and prognosis of NHL. Prophylactic lamivudine should be considered in all HBV-infected patients receiving antracycline and/or steroid containing chemotherapy.
本研究旨在评估乙型肝炎病毒（HBV）与淋巴瘤之间的关联，并对HBV相关淋巴瘤进行特征描述。同时还评估了预防性拉米夫定对HBV再激活的疗效。
我们比较了4年期间556例淋巴瘤患者中HBV感染的患病率与4698例年龄在18 - 69岁参与全国健康调查的新加坡居民中的患病率。接下来，我们比较了HBV阳性和HBV阴性淋巴瘤病例的临床病理特征。
我们研究中HBV感染的患病率为10.3%（57/556），高于普通人群4.1%（192/4698）的患病率（P≤0.001）。在男女两性以及不同年龄组中均观察到较高的患病率。非霍奇金淋巴瘤（NHL）存在关联，但霍奇金淋巴瘤不存在关联。在年龄、东部肿瘤协作组（ECOG）评分、结外受累、乳酸脱氢酶（LDH）水平、分期、完全缓解率和总生存率方面，HBV感染的淋巴瘤患者特征与未感染HBV的患者相似。使用预防性拉米夫定显著降低了HBV再激活的发生率（13%对38%，P = 0.02）以及化疗中断率（43%对4%，P = 0.02），且有总生存率改善的趋势。
我们的研究结果表明HBV感染与NHL之间存在关联。然而，HBV感染似乎对NHL的临床特征和预后没有显著影响。对于所有接受含蒽环类和/或类固醇化疗的HBV感染患者，应考虑使用预防性拉米夫定。
