J Cancer 2019; 10(15):3450-3458. doi:10.7150/jca.31033

Research Paper

Chronic hepatitis B virus infection is associated with a poorer prognosis in diffuse large B-cell lymphoma: a meta-analysis and systemic review

Xingyu Rong1,2#, Hai Wang1,2#, Jiexian Ma2#, Shaokun Pan1, Huijing Wang2,3✉, Sha Jing1,4, Yu Su1, Lancui Wang1, Chao Zhao1,2,4✉

1. MOE/NHC/CAMS Key Lab of Medical Molecular Virology, School of Basic Medical Sciences & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200032, P.R. China
2. Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Shanghai, 200040, P.R. China
3. Laboratory of Neuropsychopharmacology, College of Fundamental Medicine, Shanghai University of Medicine & Health Science, 201318, P.R. China
4. Institute for Basic Research on Aging and Medicine, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Shanghai, 200032, P.R. China.
#These authors contributed equally.

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Citation:
Rong X, Wang H, Ma J, Pan S, Wang H, Jing S, Su Y, Wang L, Zhao C. Chronic hepatitis B virus infection is associated with a poorer prognosis in diffuse large B-cell lymphoma: a meta-analysis and systemic review. J Cancer 2019; 10(15):3450-3458. doi:10.7150/jca.31033. Available from http://www.jcancer.org/v10p3450.htm

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Abstract

Accumulating evidence from clinical trials indicates chronic hepatitis B virus (HBV) infection is associated with the incidence of diffuse large B-cell lymphoma (DLBCL) and may be associated with the prognosis of DLBCL, though this suggestion remains controversial. We performed a meta-analysis to assess whether HBV infection is associated with prognosis and response to chemotherapy in DLBCL. After a strict literature search strategy, a total of 809 HBV surface antigen (HBsAg) seropositive patients with DLBCL and 2849 HBsAg seronegative patients with DLBCL from twelve trials were included. DLBCL patients with chronic HBV infection had significantly poorer 2- and 5-year overall survival (OS) (HR 1.54, 95% CI 1.23-1.92, P<0.001 and 1.79, 1.48-2.17, P<0.001) and 2- and 5-year progression-free survival (PFS) (HR 1.44, 95% CI 1.14-1.81, P=0.002 and HR 1.34, 95% CI 1.02-1.75, P=0.03). HBsAg-seronegative patients also had a lower complete response (CR) rate (OR 0.48, 95% CI 0.34-0.68, P<0.001), higher progressive disease (PD) rate (OR 2.08, 95% CI 1.34-3.24, P=0.001), and more advanced clinical features. This meta-analysis indicates HBV infection leads to a poorer prognosis and poorer response to standard chemotherapy.

Keywords: Hepatitis B virus, Diffuse Large B Cell Lymphoma, Prognosis, Clinical outcome, Systematic review