Objective: To evaluate the clinical and prognostic significance of hepatitis B virus infection on patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL). Methods: A retrospective analysis was performed in 81 relapsed/refractory DLBCL cases who were treated with salvage regimens from January 2004 to November 2016. The patients were divided into two group, HBsAg positive and HBsAg negative group, and assessed the clinical features and survival time of two groups. Results: Twenty-four (29.6%) patients were HBsAg positive and 57(70.4%) were negative. HBsAg-positive DLBCL patients showed unique clinical features, including more younger patients (P=0.005), more advanced Ann Arbor stage (P<0.001), high-risk IPI (P=0.010), more hypohemoglobin (P=0.015), especially extra-nodal involvement (P=0.038) and recurrence (P=0.002). Overall response rate (29.2% vs 68.4%, χ(2)=10.720, P=0.001) and median overall survival time [(11.3±2.9) months vs (30.0±7.6) months, χ(2)=28.175, P<0.001] were inferior in HBsAg-positive patients, respectively. Conclusion: To strictly control HBV infection plays an important role on the survival and prognosis of relapsed/refractory lymphoma patients.
目的： 研究乙型肝炎病毒（HBV）感染对复发难治性弥漫大B细胞淋巴瘤（DLBCL）的疗效及预后的影响。 方法： 回顾性分析2004年1月至2016年11月81例复发难治性DLBCL患者，根据乙型肝炎表面抗原（HBsAg）的情况将患者分为HBsAg阳性和HBsAg阴性两组，比较两组患者的临床特征、疗效和预后。 结果： 全部81例复发难治性DLBCL患者中，HBsAg阳性患者24例（29.6%），HBsAg阴性患者57例（70.4%）。相较于HBsAg阴性组，HBsAg阳性组年轻患者更多（P=0.005）、Ann Arbor分期以Ⅲ~Ⅳ期为主（P<0.001）、国际预后指数（IPI）3~5分居多（P=0.010）、常出现血红蛋白减低（P=0.015）、常存在两处及以上结外累及（P=0.038）、更倾向结外复发（P=0.002），总有效率低（29.2%对68.4%，χ(2)=10.720，P=0.001），中位生存时间短[（11.3±2.9）个月对（30.0±7.6）个月，χ(2)=28.175，P<0.001]。 结论： 严格控制HBV感染对复发难治性DLBCL患者生存及预后具有显著影响。.
Keywords: Hepatitis B virus; Lymphoma, large B-cell, diffuse; Recurrence; Refractory.