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[CHOP和R-CHOP方案治疗的HBsAg阴性/HBcAb阳性弥漫性大B细胞淋巴瘤患者肝功能的比较分析]

[Comparative analysis of liver function in HBsAg-/HBcAb+ patients with diffuse large B-cell lymphoma treated with CHOP and R-CHOP regimens].

作者信息

Huang Yan-hua, He Xiao-hui, Qin Yan, Yang Sheng, Lü Zheng, Dong Mei, Zhou Sheng-yu, Liu Peng, Zhang Chang-gong, Yang Jian-liang, Shi Yuan-kai

机构信息

Department of Medical Oncology, Chinese Academy Medical Sciences, Beijing, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2012 May;34(5):385-9. doi: 10. 3760/cma.j.issn.0253-3766.2012.05.016.

Abstract

OBJECTIVE

To analyze the liver function in patients with diffuse large B-cell lymphoma(DLBCL), who are hepatitis B surface antigen negative/antibody to hepatitis B core antigen positive (HBsAg-/HBcAb+), treated with CHOP and R-CHOP regimens.

METHODS

In this retrospective study, 86 DLBCL patients, who were HBsAg-/HBcAb+, were collected from Cancer Hospital of Chinese Academy of Medical Sciences between January 2005 and December 2008. The patients were given at least two cycles of chemotherapy using CHOP-like or R-CHOP-like regimen without anti-HBV treatment, and followed-up for at least 12 months after completion of therapy.

RESULTS

Forty-seven patients received CHOP-like regimen while 39 patients received R-CHOP-like regimen. There were no significant differences in the degree of liver dysfunction between CHOP group and R-CHOP group after the 1st, 2nd, 3rd, 4th and 6th cycles (22.7% - 46.7% with CHOP and 17.6% - 34.2% with R-CHOP, respectively, (all P > 0.05), except for the 5th cycles (28.6% vs. 6.2%, P = 0.026). Liver function in most patients in CHOP group and R-CHOP group was normal after every cycle (53.3% - 77.3% and 65.8%-93.8%, respectively). Meanwhile, there were no significant differences in the degree of liver dysfunction between CHOP group and R-CHOP group in the 1st-3rd month, 4th-6th month, 7th-9th month and 10th-12th month after completion of therapy (7.7% - 40.0% with CHOP and 7.4% - 32.0% with R-CHOP, respectively, all P > 0.05).

CONCLUSIONS

The present study reveals a low incidence of liver dysfunction in HBsAg-/HBcAb+ DLBCL patients, both in CHOP group and in R-CHOP group. It may indicate a potential low incidence of HBV reactivation in these groups, and Rituximab do not increase the rate of liver dysfunction. Therefore, these data may not support regularly prophylactic antiviral therapy during chemotherapy, but close monitoring of liver function, HBV serum markers and HBV DNA level are demanded.

摘要

目的

分析采用CHOP和R-CHOP方案治疗的乙肝表面抗原阴性/乙肝核心抗体阳性(HBsAg-/HBcAb+)的弥漫性大B细胞淋巴瘤(DLBCL)患者的肝功能。

方法

在这项回顾性研究中,收集了2005年1月至2008年12月期间中国医学科学院肿瘤医院的86例HBsAg-/HBcAb+的DLBCL患者。患者接受至少两个周期的类似CHOP或类似R-CHOP方案化疗,未进行抗乙肝病毒治疗,并在治疗结束后随访至少12个月。

结果

47例患者接受类似CHOP方案,39例患者接受类似R-CHOP方案。在第1、2、3、4和6周期后,CHOP组和R-CHOP组的肝功能损害程度无显著差异(CHOP组为22.7%-46.7%,R-CHOP组为17.6%-34.2%,均P>0.05),但第5周期除外(28.6%对6.2%,P=0.026)。CHOP组和R-CHOP组的大多数患者在每个周期后肝功能正常(分别为53.3%-77.3%和65.8%-93.8%)。同时,在治疗结束后的第1-3个月、第4-6个月、第7-9个月和第10-12个月,CHOP组和R-CHOP组的肝功能损害程度无显著差异(CHOP组为7.7%-40.0%,R-CHOP组为7.4%-32.0%,均P>0.05)。

结论

本研究显示,CHOP组和R-CHOP组中HBsAg-/HBcAb+的DLBCL患者肝功能损害发生率较低。这可能表明这些组中乙肝病毒再激活的潜在发生率较低,且利妥昔单抗不会增加肝功能损害的发生率。因此,这些数据可能不支持在化疗期间常规进行预防性抗病毒治疗,但需要密切监测肝功能、乙肝血清标志物和乙肝病毒DNA水平。

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