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Screening for hepatitis B in patients with lymphoma
Jonathan Ramirez1, Anupama Thadareddy Duddempudi1, Moazzam M Sana1
1Texas A&M University Health Science Center and Baylor Scott and White Health/Scott & White Memorial Hospital, Temple, Texas.
Proceedings (Baylor University. Medical Center)
|October 2, 2015
Summary
Hepatitis B virus (HBV) screening rates in lymphoma patients increased significantly after adding a checkbox to rituximab orders. This simple intervention improved HBV screening adherence for patients undergoing chemotherapy.
Area of Science:
- Oncology
- Hepatology
- Infectious Diseases
Background:
- Chronic hepatitis B virus (HBV) reactivation is a risk during lymphoma chemotherapy, particularly with rituximab.
- Guidelines recommend HBV screening for patients receiving cytotoxic or immunosuppressive therapy.
Purpose of the Study:
- To assess HBV screening rates at an institution.
- To evaluate the impact of a rituximab order checkbox on HBV screening.
Main Methods:
- Retrospective chart review of 452 lymphoma patients across two cohorts (pre- and post-protocol initiation).
- Cohort 1 (1993-2008) and Cohort 2 (2011 onwards) were compared.
- Analysis included screening rates before and after implementing an order checkbox for rituximab.
Main Results:
- Pre-protocol screening rate was low (3.7% in Cohort 1).
- Post-protocol screening rate significantly increased to 68.7% in Cohort 2.
- No HBV reactivation was observed in either cohort.
Conclusions:
- Implementing a simple checkbox on rituximab orders substantially improved HBV screening rates in lymphoma patients.
- Proactive screening is crucial for managing HBV risk in immunocompromised patients.
- The protocol change demonstrated a significant positive impact on adherence to screening guidelines.
