IS THERE A REAL INCRESED PREVALENCE OF HEPATITIS B REACTIVATION IN PATIENTS WITH CD20+ INDOLENT NON HODGKIN LYMPHOMA DURING MAINTENANCE WITH RITUXIMAB?
(Abstract release date: 05/19/16)
EHA Library. Vitagliano O. 06/09/16; 134764; PB1864
Dr. Orsola Vitagliano
Contributions
Contributions
Abstract
Abstract: PB1864
Type: Publication Only
Background
Hepatitis B reactivation is a potentially serious complication of anti CD20 antibody (Rituximab) based chemotherapy regimens although sporadic HBV reactivation cases are reported in patients on maintenance with single therapy Rituximab.
Aims
The aim of this study is to assess the prevalence of HBV reactivation among patients HBsAg-/HBcAb+ undergoing maintenance chemotherapy with Rituximab.
Methods
We have analyzed 148 patients treated for non Hodgkin’s lymphoma according to standard maintenance therapy with Rituximab (375 mg/mq every 2 months for 2 years) from January 2007 to February 2016.Patients received different chemotherapy regimens during induction: 15.5% (23/148) with RCHOP, 27% (40/148) with R-FN, 22% (23/148) R-Bendamustine, 4% ( 6/148) with R-Fludarabine, 4% (6/148) with R-Leukeran, 19% (28/148)with R-CEOP, 2% (3/148) with R-CVP, 0.6% (1/148) with R-FC, 0.6% (1/148) with R-C, 1.2 % (2/148) with R-FN and Bendamustine and 3% ( 5/148) with Rituximab monotherapy.We performed blood tests for HBV (HBsAg, HBsAb, HBeAg, HBeAb, HBcAb) and liver function tests in all patients at diagnosis and before each administration of maintence with Rituximab. Patients HBsAg-/HBcAb+ with increased level of transaminases perfmormed HBV-DNA test. Six patients with HBsAg+ received prophylactic therapy with antiviral drugs during induction and maintenance therapy.
Results
69.6% of the patients (103/148) completed therapy with Rituximab and 30.4% of the patients (45/148) are still in maintenance therapy : 32% of the all patients (47/148) were HBcAb+ positive.Only 4.2% (2/47) of these patients occurred HBV reactivation.
Conclusion
In clinical practice patients HBsAg-/HBcAB+ treated with Rituximab in single therapy are normally considered for prophylaxis with lamivudine.In our experience HBsAg-/HBcAB+ patients don’t received therapy with antiviral drugs during maintenance therapy with Rituximab. Only two of our patients experienced HBV reactivation during maintence therapy.In terms of cost benefit analysis there is an advantage in the monitoring approach thatwas used in our patients in respect to universal prophylaxis, with a savings of about € 3.400,00 for each patient and a total cost of 159.000€ for all our patients.This study is the first study which analyzes HBV reactivation among HBcAb positive patients which underwent to maintenance therapy with Rituximab for indolent NHL.
Session topic: E-poster
Keyword(s): Hepatitis B virus, Indolent non-Hodgkin's lymphoma, Rituximab
Type: Publication Only
Background
Hepatitis B reactivation is a potentially serious complication of anti CD20 antibody (Rituximab) based chemotherapy regimens although sporadic HBV reactivation cases are reported in patients on maintenance with single therapy Rituximab.
Aims
The aim of this study is to assess the prevalence of HBV reactivation among patients HBsAg-/HBcAb+ undergoing maintenance chemotherapy with Rituximab.
Methods
We have analyzed 148 patients treated for non Hodgkin’s lymphoma according to standard maintenance therapy with Rituximab (375 mg/mq every 2 months for 2 years) from January 2007 to February 2016.Patients received different chemotherapy regimens during induction: 15.5% (23/148) with RCHOP, 27% (40/148) with R-FN, 22% (23/148) R-Bendamustine, 4% ( 6/148) with R-Fludarabine, 4% (6/148) with R-Leukeran, 19% (28/148)with R-CEOP, 2% (3/148) with R-CVP, 0.6% (1/148) with R-FC, 0.6% (1/148) with R-C, 1.2 % (2/148) with R-FN and Bendamustine and 3% ( 5/148) with Rituximab monotherapy.We performed blood tests for HBV (HBsAg, HBsAb, HBeAg, HBeAb, HBcAb) and liver function tests in all patients at diagnosis and before each administration of maintence with Rituximab. Patients HBsAg-/HBcAb+ with increased level of transaminases perfmormed HBV-DNA test. Six patients with HBsAg+ received prophylactic therapy with antiviral drugs during induction and maintenance therapy.
Results
69.6% of the patients (103/148) completed therapy with Rituximab and 30.4% of the patients (45/148) are still in maintenance therapy : 32% of the all patients (47/148) were HBcAb+ positive.Only 4.2% (2/47) of these patients occurred HBV reactivation.
Conclusion
In clinical practice patients HBsAg-/HBcAB+ treated with Rituximab in single therapy are normally considered for prophylaxis with lamivudine.In our experience HBsAg-/HBcAB+ patients don’t received therapy with antiviral drugs during maintenance therapy with Rituximab. Only two of our patients experienced HBV reactivation during maintence therapy.In terms of cost benefit analysis there is an advantage in the monitoring approach thatwas used in our patients in respect to universal prophylaxis, with a savings of about € 3.400,00 for each patient and a total cost of 159.000€ for all our patients.This study is the first study which analyzes HBV reactivation among HBcAb positive patients which underwent to maintenance therapy with Rituximab for indolent NHL.
Session topic: E-poster
Keyword(s): Hepatitis B virus, Indolent non-Hodgkin's lymphoma, Rituximab
Abstract: PB1864
Type: Publication Only
Background
Hepatitis B reactivation is a potentially serious complication of anti CD20 antibody (Rituximab) based chemotherapy regimens although sporadic HBV reactivation cases are reported in patients on maintenance with single therapy Rituximab.
Aims
The aim of this study is to assess the prevalence of HBV reactivation among patients HBsAg-/HBcAb+ undergoing maintenance chemotherapy with Rituximab.
Methods
We have analyzed 148 patients treated for non Hodgkin’s lymphoma according to standard maintenance therapy with Rituximab (375 mg/mq every 2 months for 2 years) from January 2007 to February 2016.Patients received different chemotherapy regimens during induction: 15.5% (23/148) with RCHOP, 27% (40/148) with R-FN, 22% (23/148) R-Bendamustine, 4% ( 6/148) with R-Fludarabine, 4% (6/148) with R-Leukeran, 19% (28/148)with R-CEOP, 2% (3/148) with R-CVP, 0.6% (1/148) with R-FC, 0.6% (1/148) with R-C, 1.2 % (2/148) with R-FN and Bendamustine and 3% ( 5/148) with Rituximab monotherapy.We performed blood tests for HBV (HBsAg, HBsAb, HBeAg, HBeAb, HBcAb) and liver function tests in all patients at diagnosis and before each administration of maintence with Rituximab. Patients HBsAg-/HBcAb+ with increased level of transaminases perfmormed HBV-DNA test. Six patients with HBsAg+ received prophylactic therapy with antiviral drugs during induction and maintenance therapy.
Results
69.6% of the patients (103/148) completed therapy with Rituximab and 30.4% of the patients (45/148) are still in maintenance therapy : 32% of the all patients (47/148) were HBcAb+ positive.Only 4.2% (2/47) of these patients occurred HBV reactivation.
Conclusion
In clinical practice patients HBsAg-/HBcAB+ treated with Rituximab in single therapy are normally considered for prophylaxis with lamivudine.In our experience HBsAg-/HBcAB+ patients don’t received therapy with antiviral drugs during maintenance therapy with Rituximab. Only two of our patients experienced HBV reactivation during maintence therapy.In terms of cost benefit analysis there is an advantage in the monitoring approach thatwas used in our patients in respect to universal prophylaxis, with a savings of about € 3.400,00 for each patient and a total cost of 159.000€ for all our patients.This study is the first study which analyzes HBV reactivation among HBcAb positive patients which underwent to maintenance therapy with Rituximab for indolent NHL.
Session topic: E-poster
Keyword(s): Hepatitis B virus, Indolent non-Hodgkin's lymphoma, Rituximab
Type: Publication Only
Background
Hepatitis B reactivation is a potentially serious complication of anti CD20 antibody (Rituximab) based chemotherapy regimens although sporadic HBV reactivation cases are reported in patients on maintenance with single therapy Rituximab.
Aims
The aim of this study is to assess the prevalence of HBV reactivation among patients HBsAg-/HBcAb+ undergoing maintenance chemotherapy with Rituximab.
Methods
We have analyzed 148 patients treated for non Hodgkin’s lymphoma according to standard maintenance therapy with Rituximab (375 mg/mq every 2 months for 2 years) from January 2007 to February 2016.Patients received different chemotherapy regimens during induction: 15.5% (23/148) with RCHOP, 27% (40/148) with R-FN, 22% (23/148) R-Bendamustine, 4% ( 6/148) with R-Fludarabine, 4% (6/148) with R-Leukeran, 19% (28/148)with R-CEOP, 2% (3/148) with R-CVP, 0.6% (1/148) with R-FC, 0.6% (1/148) with R-C, 1.2 % (2/148) with R-FN and Bendamustine and 3% ( 5/148) with Rituximab monotherapy.We performed blood tests for HBV (HBsAg, HBsAb, HBeAg, HBeAb, HBcAb) and liver function tests in all patients at diagnosis and before each administration of maintence with Rituximab. Patients HBsAg-/HBcAb+ with increased level of transaminases perfmormed HBV-DNA test. Six patients with HBsAg+ received prophylactic therapy with antiviral drugs during induction and maintenance therapy.
Results
69.6% of the patients (103/148) completed therapy with Rituximab and 30.4% of the patients (45/148) are still in maintenance therapy : 32% of the all patients (47/148) were HBcAb+ positive.Only 4.2% (2/47) of these patients occurred HBV reactivation.
Conclusion
In clinical practice patients HBsAg-/HBcAB+ treated with Rituximab in single therapy are normally considered for prophylaxis with lamivudine.In our experience HBsAg-/HBcAB+ patients don’t received therapy with antiviral drugs during maintenance therapy with Rituximab. Only two of our patients experienced HBV reactivation during maintence therapy.In terms of cost benefit analysis there is an advantage in the monitoring approach thatwas used in our patients in respect to universal prophylaxis, with a savings of about € 3.400,00 for each patient and a total cost of 159.000€ for all our patients.This study is the first study which analyzes HBV reactivation among HBcAb positive patients which underwent to maintenance therapy with Rituximab for indolent NHL.
Session topic: E-poster
Keyword(s): Hepatitis B virus, Indolent non-Hodgkin's lymphoma, Rituximab
{{ help_message }}
{{filter}}