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A Prospective Study of Preemptive Tenofovir Disoproxil Fumarate Therapy in HBsAg-Positive Patients with Diffuse Large B-Cell Lymphoma Receiving Rituximab Plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone
- Title
- A Prospective Study of Preemptive Tenofovir Disoproxil Fumarate Therapy in HBsAg-Positive Patients with Diffuse Large B-Cell Lymphoma Receiving Rituximab Plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone
- Authors
- Kim D.Y.; Kim Y.R.; Suh C.; Yoon D.H.; Yang D.-H.; Park Y.; Eom H.S.; Lee J.-O.; Kwak J.-Y.; Kang H.J.; Hyun S.Y.; Jo J.-C.; Chang M.H.; Yoo K.H.; Lim S.-N.; Shin H.-J.; Kim W.S.; Kim I.-H.; Kim M.K.; Kim H.J.; Lee W.-S.; Mun Y.-C.; Kim J.S.
- Ewha Authors
- 문영철
- SCOPUS Author ID
- 문영철
- Issue Date
- 2023
- Journal Title
- American Journal of Gastroenterology
- ISSN
- 2927-9270
- Citation
- American Journal of Gastroenterology vol. 118, no. 8, pp. 1373 - 1380
- Keywords
- antiviral therapy; diffuse large B-cell lymphoma; hepatitis B virus; tenofovir disoproxil fumarate
- Publisher
- Wolters Kluwer Health
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- INTRODUCTION:This prospective study aimed to investigate the efficacy and safety of preemptive antiviral therapy with tenofovir disoproxil fumarate (TDF) for HBsAg-positive patients with newly diagnosed diffuse large B-cell lymphoma receiving rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy.METHODS:We enrolled 73 patients from 20 institutions. The primary end point was the absolute risk of hepatitis B virus (HBV)-related hepatitis during preemptive TDF therapy and for 24 weeks after withdrawal from TDF. Hepatitis was defined as a more than 3-fold increase in serum alanine aminotransferase from baseline or an alanine aminotransferase level of ≥100 U/L. HBV-related hepatitis was defined as hepatitis with an increase in serum HBV-DNA to >10 times that of the pre-exacerbation baseline or an absolute increase of ≥20,000 IU/mL compared with the baseline.RESULTS:No patient developed HBV reactivation or HBV-related hepatitis during preemptive antiviral therapy (until 48 weeks after completion of R-CHOP chemotherapy) with TDF. All adverse events were grade 1 or 2. HBV reactivation was reported in 17 (23.3%) patients. All HBV reactivation was developed at a median of 90 days after withdrawal from TDF (range, 37-214 days). Six (8.2%) patients developed HBV-related hepatitis at a median of 88 days after withdrawal from TDF (range, 37-183 days).DISCUSSION:Preemptive TDF therapy in HBsAg-positive patients with diffuse large B-cell lymphoma receiving R-CHOP chemotherapy was safe and effective for preventing HBV-related hepatitis. However, a long-term maintenance strategy of preemptive TDF therapy should be recommended because of the relatively high rate of HBV-related hepatitis after withdrawal from TDF (ClinicalTrials.gov ID: NCT02354846). © 2023 Wolters Kluwer Health. All rights reserved.
- DOI
- 10.14309/ajg.0000000000002185
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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