Evaluation of hepatitis B virus screening and reactivation in patients with hematological malignancies receiving rituximab-based chemoimmunotherapy: A single-center retrospective study

Abstract

Introduction

Hepatitis B reactivation (HBVr) is a serious problem in patients with B-cell lymphoproliferative neoplasms receiving rituximab-based chemoimmunotherapy. This retrospective study aimed to evaluate the use of hepatitis B virus (HBV) screening and antiviral prophylaxis.

Methods

Data from 577 patients treated between 2000 and 2017 were retrospectively analyzed, and screening efficacy before and after 2010 was compared.

Results

HBsAg, anti-HBs and anti-HBc IgG screening were determined as effective screening, and a significant improvement was achieved in effective screening in the second period. 47 patients received antiviral prophylaxis. 16 of 18 (3.1%) patients with HBVr were not receiving prophylaxis. The mean time to reactivation was 18.1 months after the start of chemoimmunotherapy, and one patient (0.2%) died of HBVr.

Conclusions

The findings highlight the critical importance of pretreatment HBV screening and prophylaxis to protect patients from the adverse consequences of reactivation. The study concludes that lamivudine may be a suitable prophylaxis option in selected patients.

Keywords

rituximab hepatitis B reactivation B-cell lymphoproliferative neoplasm

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