医学
胃肠病学
乙型肝炎表面抗原
内科学
乙型肝炎病毒
乙型肝炎
美罗华
强的松
化疗
淋巴瘤
切碎
肝炎
长春新碱
免疫学
环磷酰胺
病毒
作者
Do Young Kim,Yu Ri Kim,Cheolwon Suh,Dok Hyun Yoon,Deok‐Hwan Yang,Yong Park,Hyeon Seok Eom,Jeong‐Ok Lee,Jae‐Yong Kwak,Hye Jin Kang,Shin Young Hyun,Jae‐Cheol Jo,Myung Hee Chang,Kwai Han Yoo,Sung-Nam Lim,Ho‐Jin Shin,Won Seog Kim,Inho Kim,Min Kyung Kim,Hyo Jung Kim,Won-Sik Lee,Yeung‐Chul Mun,Jin Seok Kim
标识
DOI:10.14309/ajg.0000000000002185
摘要
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).
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