IntroductionHepatitis B reactivation (HBVr) is a serious problem in patients with B-cell lymphoproliferative neoplasms receiving rituximab-based chemoimmunotherapy. This retrospective study aimed to evaluate the use of hepatitis B virus (HBV) screening and antiviral prophylaxis.MethodsData from 577 patients treated between 2000 and 2017 were retrospectively analyzed, and screening efficacy before and after 2010 was compared.ResultsHBsAg, anti-HBs and anti-HBc IgG screening were determined as effective screening, and a significant improvement was achieved in effective screening in the second period. 47 patients received antiviral prophylaxis. 16 of 18 (3.1%) patients with HBVr were not receiving prophylaxis. The mean time to reactivation was 18.1 months after the start of chemoimmunotherapy, and one patient (0.2%) died of HBVr.ConclusionsThe findings highlight the critical importance of pretreatment HBV screening and prophylaxis to protect patients from the adverse consequences of reactivation. The study concludes that lamivudine may be a suitable prophylaxis option in selected patients.
Keywords: B-cell lymphoproliferative neoplasm; hepatitis B reactivation; rituximab.