한빛사논문
- 조회429
Kim, Do Young MD, PhD1,*; Kim, Yu Ri MD, PhD2; Suh, Cheolwon MD, PhD3; Yoon, Dok Hyun MD, PhD3; Yang, Deok-Hwan MD, PhD4; Park, Yong MD, PhD5; Eom, Hyeon Seok MD, PhD6; Lee, Jeong-Ok MD, PhD7; Kwak, Jae-Yong MD, PhD8; Kang, Hye Jin MD, PhD9; Hyun, Shin Young MD, PhD10; Jo, Jae-Cheol MD, PhD11; Chang, Myung Hee MD, PhD12; Yoo, Kwai Han MD, PhD13; Lim, Sung-Nam MD, PhD14; Shin, Ho-Jin MD, PhD15; Kim, Won Seog MD, PhD16; Kim, In-Ho MD, PhD17; Kim, Min Kyung MD, PhD18; Kim, Hyo Jung MD, PhD19; Lee, Won-Sik MD, PhD20; Mun, Yeung-Chul MD, PhD21; Kim, Jin Seok MD, PhD2,*
1Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea;
2Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea;
3Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;
4Department of Hematology/Oncology, Chonnam National University Hwasun Hospital, Jeollanam-do, Korea;
5Department of Internal Medicine, Korea University Medical Center, Seoul, Korea;
6Hematology-Oncology Clinic, National Cancer Center, Goyang, Korea;
7Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea;
8Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea;
9Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea;
10Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea;
11Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea;
12Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea;
13Departments of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea;
14Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea;
15Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea;
16Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea;
17Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea;
18Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea;
19Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea;
20Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea;
21Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
*Do Young Kim and Jin Seok Kim contributed equally to this work.
Correspondence: Jin Seok Kim, MD, PhD
Abstract
Introduction: This prospective study aimed to investigate the efficacy and safety of preemptive antiviral therapy with tenofovir disoproxil fumarate (TDF) for HBsAg-positive patients with newly diagnosed diffuse large B-cell lymphoma receiving rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy.
Methods: We enrolled 73 patients from 20 institutions. The primary end point was the absolute risk of hepatitis B virus (HBV)-related hepatitis during preemptive TDF therapy and for 24 weeks after withdrawal from TDF. Hepatitis was defined as a more than 3-fold increase in serum alanine aminotransferase from baseline or an alanine aminotransferase level of ≥100 U/L. HBV-related hepatitis was defined as hepatitis with an increase in serum HBV-DNA to >10 times that of the pre-exacerbation baseline or an absolute increase of ≥20,000 IU/mL compared with the baseline.
Results: No patient developed HBV reactivation or HBV-related hepatitis during preemptive antiviral therapy (until 48 weeks after completion of R-CHOP chemotherapy) with TDF. All adverse events were grade 1 or 2. HBV reactivation was reported in 17 (23.3%) patients. All HBV reactivation was developed at a median of 90 days after withdrawal from TDF (range, 37-214 days). Six (8.2%) patients developed HBV-related hepatitis at a median of 88 days after withdrawal from TDF (range, 37-183 days).
Discussion: Preemptive TDF therapy in HBsAg-positive patients with diffuse large B-cell lymphoma receiving R-CHOP chemotherapy was safe and effective for preventing HBV-related hepatitis. However, a long-term maintenance strategy of preemptive TDF therapy should be recommended because of the relatively high rate of HBV-related hepatitis after withdrawal from TDF ( ClinicalTrials.gov ID: NCT02354846).
논문정보
- Research article
- 2023년 02월 (BRIC 등록일 2023-04-26)
- 국내 연구진
- 의약학 > 응용의학
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