Contributions
Type: Publication Only
Background
Anti CD20 antibody (Rituximab) based chemotherapy regimens increase the HBV reactivation risk although sporadic HBV reactivation cases are reported in patients on maintenance with Rituximab single therapy.
We evaluated how many reactivation occurred among patients Hepatitis B core antigen positive (HBcAb+) and Hepatitis B surface antigen negative (HBsAg-) who received maintenance therapy with Rituximab.
Aims
The aim of this study is to assess the prevalence of HBV reactivation among patients HBcAb+/HBsAg- during maintenance therapy with Rituximab.
Methods
Here we report our experience about 98 patients with indolent non Hodgkin Lymphoma CD20+ who received maintenance therapy with Rituximab (schedule: 375 mg/mq every 2 months for 2 years) from January 2007 to January 2015.
Patients received different chemotherapy regimens during induction: 45% (44/98) with R-CHOP, 34% (33/98) with R-FN, 13% (13/98) R-Bendamustine, 3% ( 3/98) with R-Fludarabine, 3% (3/98) with R-Leukeran and 2% ( 2/98) with Rituximab monotherapy.
We performed blood tests for HBV (HBsAg, HBsAb, HBeAg, HBeAb, HBcAb) in all patients before starting maintenance therapy and liver function tests before each administration of Rituximab. None of these patients received prophylactic therapy with antiviral drugs during induction and maintenance therapy.
Results
32% of the patients (32/98) were HBcAb positive.
58% of the patient (57/98) completed therapy with Rituximab and 30% of them (17/57) were HBcAb positive; one of these patients occurred HBV reactivation.
42% of the patients (41/98) are still in maintenance therapy and 36% of them (15/41) were HBcAb positive with risk of HBV reactivation too.
Summary
In patients HBcAB+/HBsAg- treated with Rituximab in single therapy is indicated the prophylaxis with lamivudine.
In our single centre experience HBcAB+/HBsAg- patients didn’t received therapy with antiviral drugs during maintenance therapy with Rituximab; one of our patient occurred HBV reactivation.
In terms of cost-benefit, we reported an advantage in the monitoring approach that
was used in our patients in respect to universal prophylaxis with a total savings of about € 3.400,00 for each patient.
More study are necessary to estabilish the clinical utility of prophylactic therapy with lamivudine during the maintenance therapy with Rituximab
Keyword(s): Hepatitis B virus, Maintenance, Non-Hodgkin's lymphoma, Rituximab
Session topic: Publication Only
Type: Publication Only
Background
Anti CD20 antibody (Rituximab) based chemotherapy regimens increase the HBV reactivation risk although sporadic HBV reactivation cases are reported in patients on maintenance with Rituximab single therapy.
We evaluated how many reactivation occurred among patients Hepatitis B core antigen positive (HBcAb+) and Hepatitis B surface antigen negative (HBsAg-) who received maintenance therapy with Rituximab.
Aims
The aim of this study is to assess the prevalence of HBV reactivation among patients HBcAb+/HBsAg- during maintenance therapy with Rituximab.
Methods
Here we report our experience about 98 patients with indolent non Hodgkin Lymphoma CD20+ who received maintenance therapy with Rituximab (schedule: 375 mg/mq every 2 months for 2 years) from January 2007 to January 2015.
Patients received different chemotherapy regimens during induction: 45% (44/98) with R-CHOP, 34% (33/98) with R-FN, 13% (13/98) R-Bendamustine, 3% ( 3/98) with R-Fludarabine, 3% (3/98) with R-Leukeran and 2% ( 2/98) with Rituximab monotherapy.
We performed blood tests for HBV (HBsAg, HBsAb, HBeAg, HBeAb, HBcAb) in all patients before starting maintenance therapy and liver function tests before each administration of Rituximab. None of these patients received prophylactic therapy with antiviral drugs during induction and maintenance therapy.
Results
32% of the patients (32/98) were HBcAb positive.
58% of the patient (57/98) completed therapy with Rituximab and 30% of them (17/57) were HBcAb positive; one of these patients occurred HBV reactivation.
42% of the patients (41/98) are still in maintenance therapy and 36% of them (15/41) were HBcAb positive with risk of HBV reactivation too.
Summary
In patients HBcAB+/HBsAg- treated with Rituximab in single therapy is indicated the prophylaxis with lamivudine.
In our single centre experience HBcAB+/HBsAg- patients didn’t received therapy with antiviral drugs during maintenance therapy with Rituximab; one of our patient occurred HBV reactivation.
In terms of cost-benefit, we reported an advantage in the monitoring approach that
was used in our patients in respect to universal prophylaxis with a total savings of about € 3.400,00 for each patient.
More study are necessary to estabilish the clinical utility of prophylactic therapy with lamivudine during the maintenance therapy with Rituximab
Keyword(s): Hepatitis B virus, Maintenance, Non-Hodgkin's lymphoma, Rituximab
Session topic: Publication Only