摘要
目的研究利妥昔单抗联合化疗治疗B细胞非霍奇金淋巴瘤(B—NHL)合并乙型肝炎病毒(HBV)携带患者的安全性,探讨拉米夫定预防性治疗的价值。方法回顾性分析含利妥昔单抗联合化疗前后B—NHL患者乙型肝炎五项、HBV.DNA和肝功能指标变化。将39例HBV核心抗体(HBcAb)(+)/HBV表面抗体(HBsAb)(-)的B—NHL患者分为拉米夫定预防组和对照组,比较两组化疗后HBV再激活、肝功能损害等指标。结果108例接受利妥昔单抗联合化疗的B—NHL患者中,15例患者为HBV表面抗体(HBsAg)(+),占所有患者的13.89%;39例为HBsAg(-)/HBcAb(+)患者,占所有患者的36.11%。15例HBsAg(+)的患者中HBV再激活率为13.3%,13例拉米夫定预防患者中1例(7.7%)HBV再激活,2例未预防的患者中1例HBV再激活。39例HBsAg(-)/HBcAb(+)患者中HBV再激活率为7.7%(3例),14例拉米夫定预防组HBV再激活率为0,25例未预防的患者中3例(12%)HBV再激活。结论B—NHL合并HBV携带患者在利妥昔单抗联合化疗导致HBV再激活的风险是可控的,预防性使用拉米夫定能明显降低HBV再激活。
Objective To investigate the safety of rituximab combination chemotherapy in the treatment of B-cell non-Hodgkin" s lymphoma (B-NHL) complicated with hepatitis B virus (HBV) infection, and assess the incidence of HBV reactivation reduced by prophylactic lamivudine. Methods A retrospective study of HBV-related markers, HBV-DNA and liver function was performed before and after rituximab- containing treatment in B-NHL patients. Thirty nine B-NHL patients with HBcAb(+)/HBsAb(-) were divided into prophylactic group (14 cases) and control group (25 cases). The incidences of HBV reactivation, functional damage of liver were measured. Results Among the 108 B-NHL patients who received rituximab combination chemotherapy, 15 (13.89 %) were HBsAg (+) and 39 (36.11%) HBsAg (-) / HBcAb (+). Of the 15 HBsAg (+) patients, 2 (13.3 %) experienced reactivation of HBV. The prevalence of HBV reactivation was 7.7 %(1/13) in patients who received prophylactic antiviral treatment and 50 % (1/2) in those who did not receive lamivudine. Among the 39 HBsAg (-) / HBeAb (+) patients, 3 cases (7.7 %) experienced reactivation of HBV. The prevalence of HBV reactivation was 0 in patients who received prophylactic lamivudine treatment and 12 % (3/25) in those who did not receive this antiviral drug. Conclusion Prophylactic lamivudine before rituximab combination chemotherapy can reduce HBV reactivation obviously.
出处
《白血病.淋巴瘤》
CAS
2012年第9期524-527,共4页
Journal of Leukemia & Lymphoma
基金
上海浦东新区社会发展局重点协作项目(PW2009D-5)
七海交通大学医学院附属仁济医院重点学科项目(RJ4101306)