Long-term hepatic consequences of chemotherapy-related HBV reactivation in lymphoma patients.
OBJECTIVE
To investigate the long-term consequences of chemotherapy-related HBV reactivation in patients with lymphoma.


METHODS
This study was based on the database of published prospective study evaluating HBV reactivation in HBV lymphoma patients during chemotherapy. Deteriorated liver reserve (DLR) was defined as development of either one of the following conditions during follow-up: (1) newly onset parenchyma liver disease, splenomegaly or ascites without evidence of lymphoma involvement; (2) decrease of the ratio (albumin/globulin ratio) to less than 0.8 or increase of the ratio of INR of prothrombin time to larger than 1.2 without evidence of malnutrition or infection. Liver cirrhosis was diagnosed by imaging studies.


RESULTS
A total of 49 patients were included. The median follow-up was 6.2 years (range, 3.9-8.1 years). There were 31 patients with and 18 patients without HBV reactivation. Although there was no difference of overall survival (OS) and chemotherapy response rate between the two groups, DLR developed more frequently in patients with HBV reactivation (48.4% vs 16.7%; P = 0.0342). Among the HBV reactivators, HBV genotype C was associated with a higher risk of developing DLR (P = 0.0768) and liver cirrhosis (P = 0.003). Four of five patients with sustained high titer of HBV DNA and two of three patients with multiple HBV reactivation developed DLR. Further, patients with a sustained high titer of HBV DNA had the shortest OS among the HBV reactivators (P = 0.0000). No patients in the non-HBV reactivation group developed hepatic failure or liver cirrhosis.


CONCLUSIONS
Chemotherapy-related HBV reactivation is associated with the long-term effect of deterioration of hepatic function.
Su
Wen-Pin
WP
Department of Oncology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 10016, Taiwan, China.
Wen
Chi-Chung
CC
Hsiung
Chao-A
CA
Su
Ih-Jen
IJ
Cheng
Ann-Lii
AL
Chang
Ming-Chih
MC
Tsao
Chao-Jung
CJ
Kao
Woei-Yao
WY
Uen
Wu-Ching
WC
Hsu
Chiun
C
Hsu
Chih-Hung
CH
Lu
Yen-Shen
YS
Tien
Hwei-Fan
HF
Chao
Tsu-Yi
TY
Chen
Li-Tzong
LT
Whang-Peng
Jacqueline
J
Chen
Pei-Jer
PJ
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000453:epidemiology; D008223:Lymphoma / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors
D000970:Antineoplastic Agents