Treated chronic hepatitis B is a good prognostic factor of diffuse large B-cell lymphoma

• Published in: Clinical and molecular hepatology Vol. 29; no. 3; pp. 794 - 809
• Main Authors: Jeayeon Park, Sung Won Chung, Yun Bin Lee, Hyunjae Shin, Moon Haeng Hur, Heejin Cho, Min Kyung Park, Jeonghwan Youk, Ji Yun Lee, Jeong-ok Lee, Su Jong Yu, Yoon Jun Kim, Jung-hwan Yoon, Tae Min Kim, Jeong-hoon Lee
• Format: Journal Article
• Language: Korean
• Published: 대한간학회 01-07-2023
• Subjects: Antiviral agent; Chemotherapy; Hepatitis B virus; Non-Hodgkin lymphoma; Rituximab
• ISSN: 2287-2728; 2287-285X

Background/Aims: Chronic hepatitis B (CHB) is a risk factor for non-Hodgkin lymphoma (NHL). Our recent study suggested that antiviral treatment may reduce the incidence of NHL in CHB patients. This study compared the prognoses of hepatitis B virus (HBV)-associated diffuse large B-cell lymphoma (DLBCL) patients receiving antiviral treatment and HBV-unassociated DLBCL patients.
Methods: This study comprised 928 DLBCL patients who were treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) at two referral centers in Korea. All patients with CHB received antiviral treatment. Time-to-progression (TTP) and overall survival (OS) were the primary and secondary endpoints, respectively.
Results: Among the 928 patients in this study, 82 were hepatitis B surface antigen (HBsAg)-positive (the CHB group) and 846 were HBsAg-negative (the non-CHB group). The median follow-up time was 50.5 months (interquartile range [IQR]=25.6-69.7 months). Multivariable analyses showed longer TTP in the CHB group than the non-CHB group both before inverse probability of treatment weighting (IPTW; adjusted hazard ratio [aHR]=0.49, 95% confidence interval [CI]=0.29-0.82, P=0.007) and after IPTW (aHR=0.42, 95% CI=0.26-0.70, P<0.001). The CHB group also had a longer OS than the non-CHB group both before IPTW (HR=0.55, 95% CI=0.33-0.92, log-rank P=0.02) and after IPTW (HR=0.53, 95% CI=0.32-0.99, log-rank P=0.02). Although liver-related deaths did not occur in the non-CHB group, two deaths occurred in the CHB group due to hepatocellular carcinoma and acute liver failure, respectively.
Conclusions: Our findings indicate that HBV-associated DLBCL patients receiving antiviral treatment have significantly longer TTP and OS after R-CHOP treatment than HBV-unassociated DLBCL patients. (Clin Mol Hepatol 2023;29:794- 809)