Department of Medical Oncology, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in Southern China, Guangzhou, Guangdong, China.
J Viral Hepat. 2011 Dec;18(12):877-83. doi: 10.1111/j.1365-2893.2010.01386.x. Epub 2010 Nov 5.
During chemotherapy for lymphoma, the administration of cytotoxic agents and rituximab often results in hepatitis B reactivation (incidence, 14-72%). This study was designed to compare the efficacy of entecavir and lamivudine in preventing hepatitis B reactivation in lymphoma patients. Between January 2007 and February 2009, patients treated in four hospitals in China were screened to identify those most appropriate for analysis. These patients received either entecavir or lamivudine during chemotherapy and for 6 months after completion of chemotherapy. A total of 34 patients received entecavir and 89 patients received lamivudine. Compared with the lamivudine group, the entecavir group had significantly lower rates of hepatitis (5.9 vs 27.0%, P = 0.007), hepatitis B reactivation (0 vs 12.4%, P = 0.024) and disruption of chemotherapy (5.9 vs 20.2%, P = 0.042). All patients with hepatitis B reactivation had B-cell non-Hodgkin's lymphoma (stage III-IV). In lymphoma patients under chemotherapy treatment, entecavir is more effective than lamivudine in preventing hepatitis B reactivation. For patients with advanced stage disease, entecavir should be considered the primary preventive therapy.
在淋巴瘤的化疗过程中，细胞毒性药物和利妥昔单抗的给药常常导致乙型肝炎再激活（发生率为 14-72%）。本研究旨在比较恩替卡韦和拉米夫定在预防淋巴瘤患者乙型肝炎再激活方面的疗效。
2007 年 1 月至 2009 年 2 月，在中国的四家医院筛选接受治疗的患者，以确定最适合分析的患者。这些患者在化疗期间和化疗结束后 6 个月内接受恩替卡韦或拉米夫定治疗。共有 34 名患者接受恩替卡韦治疗，89 名患者接受拉米夫定治疗。与拉米夫定组相比，恩替卡韦组乙型肝炎（5.9%比 27.0%，P = 0.007）、乙型肝炎再激活（0%比 12.4%，P = 0.024）和化疗中断（5.9%比 20.2%，P = 0.042）的发生率显著降低。所有乙型肝炎再激活的患者均患有 B 细胞非霍奇金淋巴瘤（III-IV 期）。在接受化疗治疗的淋巴瘤患者中，恩替卡韦在预防乙型肝炎再激活方面比拉米夫定更有效。对于晚期疾病患者，应考虑使用恩替卡韦作为主要预防治疗。
