title: Prognostic analysis of acute exacerbations of hepatitis-B after chemotherapy in combination with rituximab in 19 patients with lymphoma.
abstract: The prognosis and management of acute exacerbations of hepatitis-B in patients with lymphoma after chemotherapy in combination with rituximab remain unclear. Here, we describe 19 Chinese patients with lymphoma who suffered this complication, in order to analyze their clinical characteristics. Receiver operating characteristic analysis and Kaplan-Meier survival analysis were utilized to determine potential prognostic factors. We found that key prognostic factors included the peak prothrombin time (PT), international normalized ratio (INR), and total bilirubin (TB), as well as the PT and INR on admission and the interval between acute exacerbation of hepatitis-B and the last cycle of chemotherapy. Moreover, our data suggested that shorter interval between the last cycle of rituximab and acute exacerbation of hepatitis-B might be another prognostic indicator of inferior survival. Our results revealed that the severity of hepatic damage and the interval between the last cycle of chemotherapy and hepatitis flare were the major prognostic factors of an acute exacerbation of hepatitis-B induced by immunochemotherapy. Prophylactic antiviral and rescue antiviral therapy remain to be further characterized.
authors.affiliation: Department of Medical Oncology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Xing
authors.initials: X
authors.lastname: Li
authors.forename: Qu
authors.initials: Q
authors.lastname: Lin
authors.forename: Min
authors.initials: M
authors.lastname: Dong
authors.forename: Jing-Yun
authors.initials: JY
authors.lastname: Wen
authors.forename: Li
authors.initials: L
authors.lastname: Wei
authors.forename: Xiao-Kun
authors.initials: XK
authors.lastname: Ma
authors.forename: Zhan-Hong
authors.initials: ZH
authors.lastname: Chen
authors.forename: Xiang-Yuan
authors.initials: XY
authors.lastname: Wu
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D001663:Bilirubin / Q000378:metabolism; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004279:DNA, Viral / Q000235:genetics; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000188:drug therapy / Q000209:etiology*; D006515:Hepatitis B virus / Q000502:physiology*; D006801:Humans; D008111:Liver Function Tests; D018442:Lymphoma, B-Cell, Marginal Zone / Q000821:virology*; D008224:Lymphoma, Follicular / Q000821:virology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000821:virology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011379:Prognosis; D011517:Prothrombin Time; D000069283:Rituximab; D015996:Survival Rate; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects; D014775:Virus Activation / Q000187:drug effects*
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000998:Antiviral Agents; D004279:DNA, Viral; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D001663:Bilirubin; D011241:Prednisone