Hepatitis B Virus Antibody as Potential Biomarker to Predict the Effect of Rituximab in Diffuse Large B-cell Lymphoma Patients

Abstract Background: Diffuse large B-cell lymphoma (DLBCL) has been correlated with virus infection and immunity status. Hepatitis B virus (HBV) infection is a significant public health problem around the world, especially in China. Previous research regarding the association of non-Hodgkin lymphoma (NHL) and HBV mostly focused on HBV antigen and HBV DNA. This study aimed to evaluate the relationship between HBV antibody and clinical prognosis in DLBCL. Methods: We retrospectively investigated the clinical characteristics of 190 newly diagnosed and untreated DLBCL patients and did a follow-up study. Results: Compared with HBeAb- patients, HBeAb+ patients displayed unique clinical features, such as more advanced disease stage (p=0.031) and higher International Prognostic Index (IPI) score (p=0.015). HBV antibody-negative patients had better therapeutic efficiency than positive patients (p<0.05). The media progression-free survival (PFS) and overall survival (OS) of HBV antibody-positive group were shorter than the negative group, respectively (p<0.05). Furthermore, we found positive association between CD21 and HBsAb (p=0.06) and their synergistic effect for prognostic predication. Interestingly, the effect of Rituximab in prognostic improvement was more significant in HBV antibody-positive group than negative group. Univariate analysis showed that HBV antibody status was independent risk factor for prognosis of DLBCL patients. Conclusions: Taken together, our investigations identified for the first time the close association between HBV antibody and clinical prognosis and Rituximab responses in DLBCL patients. These findings indicate the novel association between HBV infection and DLBCL prognosis, provide potential biomarker to predict the effect of Rituximab, and offer novel insights into the role of immune response to HBV infection in DLBCL progression.