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Clinicopathological and prognostic features of hepatitis B virus-associated diffuse large B-cell lymphoma: a single-center retrospective study in China.
- Source :
- Infectious Agents & Cancer; 8/17/2021, Vol. 16 Issue 1, p1-11, 11p
- Publication Year :
- 2021
-
Abstract
- Background: While the epidemiologic association between hepatitis B virus (HBV) infection and diffuse large B-cell lymphoma (DLBCL) is established, little is known about the pathological characteristics and outcome of DLBCL arising in patients with HBV infection. Methods: We retrospectively studied a cohort of 420 patients with DLBCL for the incidence of HBV infection, and the clinicopathologic features and prognostic factors in HBsAg-positive DLBCL patients in China, a hepatitis B endemic area. Results: In our study, 127 (30.2%) patients were HBsAg-positive. HBsAg-positive DLBCL displayed a younger median onset age (50 vs. 54 years, P = 0.002), more frequent involvement of the spleen (19.7% vs. 6.1%, P < 0.001), less frequent involvement of the small and large intestine (2.3% vs. 11.2%, P = 0.003), more advanced disease (stage III/IV: 56.7% vs. 45.1%, P = 0.028), and lower expression rate of MYC (49.1% vs. 66.7%, P = 0.026). The median follow-up time was 61.9 months. Univariate analysis showed that there was no significant difference in overall survival (OS) between HBsAg-negative and -positive DLBCL (P = 0.577). In the HBsAg-positive DLBCL subgroup, age older than 60 years, advanced disease, elevated lactate dehydrogenase (LDH), spleen involvement, B symptoms (fever, night sweats, weight loss), and double expressers of MYC and BCL2 had a significantly worse outcome, and patients treated with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) had a better prognosis. Multivariate analysis further confirmed that spleen involvement and rituximab use were independent prognostic factors in HBsAg-positive DLBCL patients. Conclusions: Our study indicates that HBsAg-positive DLBCL has unique clinicopathological features and independent prognostic factors. Moreover, under antiviral prophylaxis, the survival of DLBCL patients with HBV infections was comparable to that of HBV-negative patients, and the use of rituximab significantly improved OS in HBsAg-positive DLBCL patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- THERAPEUTIC use of antineoplastic agents
HEPATITIS B
MYCOBACTERIUM
VIRAL antigens
DISEASE progression
HEALTH facilities
AGE distribution
B cell lymphoma
RETROSPECTIVE studies
DISEASE incidence
CANCER patients
TUMOR classification
GENE expression
TREATMENT effectiveness
AGE factors in disease
SURVIVAL analysis (Biometry)
LACTATE dehydrogenase
SPLEEN
TUMOR antigens
INTESTINES
DISEASE complications
SYMPTOMS
Subjects
Details
- Language :
- English
- ISSN :
- 17509378
- Volume :
- 16
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Infectious Agents & Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 152012557
- Full Text :
- https://doi.org/10.1186/s13027-021-00396-x