Law M F, Lai H K, Chan H N, Ha C Y, Ng C, Yeung Y M, Yip S F
Prince of Wales Hospital, Hong Kong.
Eur J Cancer Care (Engl). 2015;24(1):117-24. doi: 10.1111/ecc.12166. Epub 2013 Dec 19.
We performed a retrospective study to analyse the characteristics and clinical outcomes of diffuse large B-cell lymphoma (DLBCL) patients with hepatitis B virus (HBV) infection and compare with those without HBV infection. The occurrence of hepatitis after withdrawal of prophylactic antiviral treatment on completion of chemotherapy was also assessed. The HBsAg-positive patients were given prophylactic antiviral treatment until 6 months after finishing chemotherapy. A total of 81 patients were recruited with 16 in the HBsAg-positive group and 65 in the HBsAg-negative group. The clinical characteristics were similar in both groups of patients. There was no significant difference in complete remission rate between the two groups (63% in HBsAg-positive group vs. 54% in HBsAg-negative group, P = 0.59). There was also no statistically significant difference in overall survival between the two groups (P = 0.23). Four of the 16 HBsAg-positive patients (25%) had hepatitis after cessation of chemotherapy and prophylactic lamivudine. The mean time of onset of hepatitis was 3 months after stopping lamivudine. In conclusion, HBV infection did not appear to affect the prognosis of DLBCL patients given antiviral prophylaxis. It is reasonable to consider prophylactic antiviral therapy to extend to at least one year on completion of chemotherapy.
我们进行了一项回顾性研究，以分析乙型肝炎病毒（HBV）感染的弥漫性大B细胞淋巴瘤（DLBCL）患者的特征和临床结局，并与未感染HBV的患者进行比较。还评估了化疗结束后停用预防性抗病毒治疗后肝炎的发生情况。HBsAg阳性患者接受预防性抗病毒治疗直至化疗结束后6个月。共招募了81例患者，其中HBsAg阳性组16例，HBsAg阴性组65例。两组患者的临床特征相似。两组的完全缓解率无显著差异（HBsAg阳性组为63%，HBsAg阴性组为54%，P = 0.59）。两组的总生存期也无统计学显著差异（P = 0.23）。16例HBsAg阳性患者中有4例（25%）在化疗和预防性拉米夫定停止后发生肝炎。肝炎发病的平均时间为停用拉米夫定后3个月。总之，HBV感染似乎不影响接受抗病毒预防的DLBCL患者的预后。化疗结束后将预防性抗病毒治疗延长至至少一年是合理的。
