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Clinical and prognostic analysis of hepatitis B virus infection in diffuse large B-cell lymphoma
Feng Wang1, Rui-hua Xu, Hui-yan Luo
1State Key Laboratory of Oncology in Southern China, Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, PRoC. fengwanggz@126.com
Insights
Hepatitis B virus (HBV) infection in diffuse large B-cell lymphoma (DLBCL) patients is linked to earlier onset and advanced stages. Hepatic dysfunction during chemotherapy significantly impacts survival in these HBV-positive DLBCL patients.
Area of Science:
- Oncology
- Hepatology
- Infectious Diseases
Background:
- Hepatitis B virus (HBV) infection is a common complication in China among patients with diffuse large B-cell lymphoma (DLBCL).
- The clinical significance of HBV infection concerning DLBCL disease progression and patient survival requires further elucidation.
- This study aims to analyze the clinical characteristics and prognostic factors associated with HBV infection in DLBCL patients.
Purpose of the Study:
- To investigate the clinical features of DLBCL patients with and without HBV infection (HBsAg-positive vs. HBsAg-negative).
- To evaluate the impact of HBV infection on disease staging and overall survival in DLBCL.
- To identify prognostic factors for HBV-infected DLBCL patients, particularly concerning chemotherapy and liver function.
Main Methods:
- A retrospective study comparing HBsAg-positive (n=81) and HBsAg-negative (n=181) DLBCL patients.
- Subgroup analysis of HBsAg-positive patients based on hepatic function during chemotherapy.
- Statistical analyses were employed to assess the significance of clinical parameters and outcomes.
Main Results:
- HBsAg-positive DLBCL patients presented with younger onset age (median 46 vs. 51 years) and more advanced stages (III/IV: 58% vs. 42%).
- Hepatic dysfunction was more frequent in HBsAg-positive patients before (21% vs. 5.5%) and during (49.4% vs. 16.6%) chemotherapy.
- Overall survival and response rates were similar between groups, but advanced stage and hepatic dysfunction during chemotherapy were poor prognostic factors in HBsAg-positive patients.
Conclusions:
- HBsAg-positive DLBCL patients exhibit earlier onset and more advanced disease compared to HBsAg-negative patients.
- Disease stage and chemotherapy-induced hepatic dysfunction are significant prognostic factors in HBsAg-positive DLBCL.
- Prophylactic HBV treatment is suggested for HBsAg-positive DLBCL patients to improve outcomes.
Background:
Hepatitis B virus (HBV) infection in diffuse large B-cell lymphoma (DLBCL) patients is a common complication in China. However, the clinical relevance of HBV infection with respect to DLBCL disease stages and patient survival remains unclear. The main objective of the current study was to analyze the clinical features and to evaluate the prognostic factors of HBV infection in DLBCL patients.
Methods:
In this retrospective study, DLBCL patients were divided into two groups as HBsAg-positive (n = 81) and HBsAg-negative (n = 181) patients. The HBsAg-positive patients were further divided into two subgroups based on their hepatic function during chemotherapy. Various statistical analyses were used to determine the significance of the relevant clinical parameters.
Results:
Compared with the HBsAg-negative group, the HBsAg-positive DLBCL group displayed a younger median onset age (46 year vs 51), more advanced stage at grade III/IV (58% vs 42%, p = 0.016), and more frequent hepatic dysfunction before (21% vs 5.5%, p < 0.001) and during (49.4% vs 16.6%, p < 0.001) chemotherapy. Female DLBCL patients exhibited a higher frequency of HBsAg positivity (p = 0.006). However, in both groups the median overall survival (OS) duration (55.8 vs 66.8 months) and response rates (91% vs 90.4%) were similar. In the HBsAg-positive DLBCL group, the poor prognostic factors were advanced stage (p < 0.001) and hepatic dysfunction during chemotherapy (p = 0.02). The OS of HBsAg-positive patients with hepatic dysfunction during chemotherapy was significantly shorter than those without liver dysfunction (p = 0.016), and the OS rates at 3 years were 48% and 72%, respectively. The use of rituximab did not increase the rates of liver dysfunction in HBsAg-positive DLBCL patients.
Conclusion:
Compared with HBsAg-negative patients, the HBsAg-positive DLBCL patients had earlier onset and more advanced stage. The disease stage and hepatic dysfunction during chemotherapy and were two significant prognostic factors in the HBsAg-positive DLBCL patients. This study suggests that prophylactic treatment of HBV may be of great importance in the cases of HBsAg-positive patients.
