Chronic hepatitis b coinfection and survival in pediatric T-ALL: A propensity-matched analysis

In this retrospective study of 251 pediatric patients with T cell acute lymphoblastic leukemia (T-ALL), chronic hepatitis B virus (HBV) infection with acute exacerbation (CHB-AE) was associated with significantly poorer outcomes. Compared to patients with HBV-negative, the CHB-AE cohort had markedly inferior 5-year event-free survival (13.24% vs. 80.58%) and overall survival. After using propensity score matching to balance baseline characteristics, the difference in event-free survival remained significant. Subgroup analyses consistently showed worse outcomes for patients with CHB-AE, particularly those with high-risk features such as elevated leukocyte counts or central nervous system involvement. The study identifies HBV coinfection as an independent adverse prognostic factor in pediatric T-ALL. These findings highlight the urgent need for prospective studies to investigate the underlying mechanisms and to develop novel therapeutic strategies for this high-risk patient subgroup.