Risk of HBV reactivation in relapsed or refractory diffuse large B-cell lymphoma patients receiving Bruton tyrosine kinase inhibitors therapy

BackgroundBruton tyrosine kinase inhibitors (BTKis) interrupt B-cell receptor signaling and thereby could potentially reactivate hepatitis B virus (HBV). However, data about the risk for HBV reactivation (HBVr) of BTKis in relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL) patients are...

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Main Authors: Ying Ni, Lixia Gao, Yan Lu, Shiguang Ye, Lili Zhou, Wenbin Qian, Aibin Liang, Ping Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-08-01
Series:Frontiers in Immunology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2022.982346/full
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author Ying Ni
Lixia Gao
Yan Lu
Shiguang Ye
Lili Zhou
Wenbin Qian
Aibin Liang
Ping Li
author_facet Ying Ni
Lixia Gao
Yan Lu
Shiguang Ye
Lili Zhou
Wenbin Qian
Aibin Liang
Ping Li
author_sort Ying Ni
collection DOAJ
description BackgroundBruton tyrosine kinase inhibitors (BTKis) interrupt B-cell receptor signaling and thereby could potentially reactivate hepatitis B virus (HBV). However, data about the risk for HBV reactivation (HBVr) of BTKis in relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL) patients are sparse.MethodsA total of 55 R/R DLBCL patients receiving BTKis therapy in the Tongji Hospital of Tongji University were enrolled. Patient clinical characteristics, treatment outcomes and details of HBVr were collected and analyzed, aiming to demonstrate the risk of HBVr in R/R DLBCL patients post BTKis therapy and the efficacy of BTKis in HBV-associated R/R DLBCL patients.ResultsOf 55 R/R DLBCL patients treated with ibrutinib (N=38) and zanubrutinib (N=17), 4 were with chronic HBV infection (HBsAg positive), 26 with resolved HBV infection (HBsAg negative and HBcAb positive) and 25 without HBV infection (HBsAg negative and HBcAb negative). In resolved HBV infection group, 2 patients developed HBVr after the use of ibrutinib and zanubrutinib respectively. Neither of them developed HBV-related hepatitis. Our finding showed that the incidence of HBVr in resolved HBV infection group was 7.69% (95% CI, 0.9-25.1%). In this study, Overall response rate (ORR) was 70.9%. 1-year overall survival (OS) rate was 80.0%. Median progression-free survival (PFS) was 4 months (95% CI, 3-5 months). In addition, HBV infection was not associated with response rates or survival among R/R DLBCL patients post BTKis treatments.ConclusionOur study suggested that HBV infection do not affect the efficacy of BTKis’ treatment. However, R/R DLBCL patients with resolved HBV infection are at a moderate risk of developing HBVr throughout BTKis treatment. Patients should be screened for HBVr during BTKis therapy.
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spelling doaj.art-79870a56710042e590c4dcd046294d012022-12-22T02:14:24ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-08-011310.3389/fimmu.2022.982346982346Risk of HBV reactivation in relapsed or refractory diffuse large B-cell lymphoma patients receiving Bruton tyrosine kinase inhibitors therapyYing Ni0Lixia Gao1Yan Lu2Shiguang Ye3Lili Zhou4Wenbin Qian5Aibin Liang6Ping Li7Department of Hematology, Tongji Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Hematology and Oncology, Karamay Central Hospital, Karamay, ChinaDepartment of Hematology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, ChinaDepartment of Hematology, Tongji Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Hematology, Tongji Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Hematology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, ChinaDepartment of Hematology, Tongji Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Hematology, Tongji Hospital, Tongji University School of Medicine, Shanghai, ChinaBackgroundBruton tyrosine kinase inhibitors (BTKis) interrupt B-cell receptor signaling and thereby could potentially reactivate hepatitis B virus (HBV). However, data about the risk for HBV reactivation (HBVr) of BTKis in relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL) patients are sparse.MethodsA total of 55 R/R DLBCL patients receiving BTKis therapy in the Tongji Hospital of Tongji University were enrolled. Patient clinical characteristics, treatment outcomes and details of HBVr were collected and analyzed, aiming to demonstrate the risk of HBVr in R/R DLBCL patients post BTKis therapy and the efficacy of BTKis in HBV-associated R/R DLBCL patients.ResultsOf 55 R/R DLBCL patients treated with ibrutinib (N=38) and zanubrutinib (N=17), 4 were with chronic HBV infection (HBsAg positive), 26 with resolved HBV infection (HBsAg negative and HBcAb positive) and 25 without HBV infection (HBsAg negative and HBcAb negative). In resolved HBV infection group, 2 patients developed HBVr after the use of ibrutinib and zanubrutinib respectively. Neither of them developed HBV-related hepatitis. Our finding showed that the incidence of HBVr in resolved HBV infection group was 7.69% (95% CI, 0.9-25.1%). In this study, Overall response rate (ORR) was 70.9%. 1-year overall survival (OS) rate was 80.0%. Median progression-free survival (PFS) was 4 months (95% CI, 3-5 months). In addition, HBV infection was not associated with response rates or survival among R/R DLBCL patients post BTKis treatments.ConclusionOur study suggested that HBV infection do not affect the efficacy of BTKis’ treatment. However, R/R DLBCL patients with resolved HBV infection are at a moderate risk of developing HBVr throughout BTKis treatment. Patients should be screened for HBVr during BTKis therapy.https://www.frontiersin.org/articles/10.3389/fimmu.2022.982346/fullHBV reactivationdiffuse large B-cell lymphomaBruton tyrosine kinase inhibitorresolved HBV infectionprognosis
spellingShingle Ying Ni
Lixia Gao
Yan Lu
Shiguang Ye
Lili Zhou
Wenbin Qian
Aibin Liang
Ping Li
Risk of HBV reactivation in relapsed or refractory diffuse large B-cell lymphoma patients receiving Bruton tyrosine kinase inhibitors therapy
Frontiers in Immunology
HBV reactivation
diffuse large B-cell lymphoma
Bruton tyrosine kinase inhibitor
resolved HBV infection
prognosis
title Risk of HBV reactivation in relapsed or refractory diffuse large B-cell lymphoma patients receiving Bruton tyrosine kinase inhibitors therapy
title_full Risk of HBV reactivation in relapsed or refractory diffuse large B-cell lymphoma patients receiving Bruton tyrosine kinase inhibitors therapy
title_fullStr Risk of HBV reactivation in relapsed or refractory diffuse large B-cell lymphoma patients receiving Bruton tyrosine kinase inhibitors therapy
title_full_unstemmed Risk of HBV reactivation in relapsed or refractory diffuse large B-cell lymphoma patients receiving Bruton tyrosine kinase inhibitors therapy
title_short Risk of HBV reactivation in relapsed or refractory diffuse large B-cell lymphoma patients receiving Bruton tyrosine kinase inhibitors therapy
title_sort risk of hbv reactivation in relapsed or refractory diffuse large b cell lymphoma patients receiving bruton tyrosine kinase inhibitors therapy
topic HBV reactivation
diffuse large B-cell lymphoma
Bruton tyrosine kinase inhibitor
resolved HBV infection
prognosis
url https://www.frontiersin.org/articles/10.3389/fimmu.2022.982346/full
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