| [Objective]This study was designed to compare the efficacy of lamivudine and entecavir in preventing hepatitis B reactivation in B-cell non-Hodgkin’s lymphoma(B-NHL)patients undergoing rituximab-based treatment.[Method]Between May 2005 and December 2013,there were 109 patients enrolled in the study,all patients treated in Hangzhou Hospital of Nanjing Medical University in China.A retrospective study of the prevalence and mortality of HBV reactivation and the rates of hepatitis in 109 cases of patients with HBV virus and B-NHL undergoing rituximab-based chemotherapy treatment were taken.A total of 79 patients received lamivudine and 30 patients received entecavir.All the patients were positivity for hepatitis B surface antigen(HBsAg).Either entecavir(0.5 mg/day)or lamivudine(100 mg/day)was administered beginning 7 days before chemotherapy and ending 6 months after completion of chemotherapy.The prevalence and mortality of HBV reactivation were retrospectively analyzed.Among of the 109 patients,twelve patients received further rituximab maintenance,once every 3 months for 2 years.Fisher’s exact test or Pearson x2 was applied for categoric variables,and the independent sample t test or Mann-Whitney U test was applied,as appropriate,for numerical variables.Two-tailed P<0.05 was regarded as statistically significant.Univariate analysis and stepwise logistic regression were conducted to analyze potential risk factors.[Result]There was no significant difference in terms of sex distribution,age,stage of disease,International Prognostic Index(IPI)core,baseline ALT levels,baseline HBV DNA levels and cycles of rituximab therapy between the two groups.Compared with the lamivudine group,the entecavir group had significantly lower rates of hepatitis(6.7%vs27.8%,P=0.019),hepatitis B reactivation(10.0%vs 31.6%,P=0.026)and disruption of chemotherapy(3.3%vs 22.8%,P=0.021),with statistical significance(P<0.05).There were no significant differences in mortality(Ovs2.5%).Most of all patients with hepatitis B reactivation had B-cell non-Hodgkin’s lymphoma(stage III-IV).For patients undergoing further rituximab maintanence treatment,9 patients were in the lamivudine group and 3 in the entecavir group.The prevalence of HBV reactivation were 66.7%and 0,respectively.[Conclusions]In B-NHL patients under rituximab combination chemotherapy treatment,entecavir is more effective than lamivudine in preventing hepatitis B reactivation.For patients with advanced stage disease,entecavir should be considered the primary preventive therapy. |
