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Journal of Cancer Research and Clinical Oncology

, Volume 144, Issue 7, pp 1309–1315 | Cite as

The prognostic role of HBV infection in chronic lymphocytic leukemia

  • Jin-Hua Liang
  • Rui Gao
  • Jun-Cheng Dai
  • Robert Peter Gale
  • Wang Li
  • Lei Fan
  • Zhi-Bin Hu
  • Wei Xu
  • Jian-Yong Li
Original Article – Cancer Research
  • 115 Downloads

Abstract

Purpose

We attempt to assess the impact of hepatis-B virus (HBV) status on the prognosis of chronic lymphocytic leukemia (CLL) using a Chinese case cohort.

Methods

Five hundred and one consecutive newly diagnosed subjects with CLL were enrolled in this case cohort. HBV infection was defined as hepatitis B surface antigen (HBsAg) positive or hepatitis-B core antibody (HBcAb) positive. Univariate and stepwise multivariate Cox regression analyses were used to screen the prognostic risk factors associated with the end point of time-to-treatment (TTT) or overall survival (OS). Bootstrap re-sampling method was used to evaluate the model’s internal validity. The discriminative ability of the models was evaluated using time-dependent receiver–operator characteristic (ROC) curves and corresponding areas under the curve (AUC).

Results

One hundred and twenty-one subjects (24%) among 501 patients were HBV positive. HBV infection was an independent predictor for the prognosis of TTT (HR = 1.37; 95% CI 1.04–1.80) or OS (HR =2.85; 95% CI 1.80–4.52). The AUCs for HBV infection were 0.62 (95% CI 0.58–0.66) for TTT and 0.69 (95% CI 0.66–0.72) for OS, respectively. When we combined HBV infection with the traditional clinical and biological factors, significant improvements for model’s discrimination were observed for TTT [AUC: 0.81 (95% CI: 0.77–0.85) vs. 0.78 (95% CI: 0.74–0.82), P < 0.001] and OS [AUC: 0.81 (95% CI 0.76–0.86) vs. 0.76 (95% CI 0.71–0.82), P < 0.001). Further bootstrap re-sampling method revealed good internal consistence for the final optimal models (Average AUC: 0.78 for TTT and 0.79 for OS based on 1000 bootstraps).

Conclusions

Our results indicated that HBV infection should be served as an important risk predictor for prognosis of CLL (TTT and OS).

Keywords

Chronic lymphocytic leukemia HBV Prognostic biomarker Overall survival Time to first treatment 

Notes

Acknowledgements

This study was founded by National Natural Science Foundation of China (81370657, 81470328, 81600130, 81770166, 81720108002), Jiangsu Province’s Medical Elite Programme (ZDRCA2016022), Project of National Key Clinical Specialty, National Science & Technology Pillar Program (2014BAI09B12), Jiangsu Provincial Special Program of Medical Science (BL2014086 and BE2017751) and National Science and Technology Major Project (2017ZX09304032).

Compliance with ethical standards

Conflict of interest

These authors have no conflicts of interest.

Supplementary material

432_2018_2663_MOESM1_ESM.doc (30 kb)
Supplementary material 1 (DOC 30 KB)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Hematology, Jiangsu Province HospitalThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
  2. 2.Key Laboratory of Hematology of Nanjing Medical UniversityNanjingChina
  3. 3.Collaborative Innovation Center for Cancer Personalized MedicineNanjingChina
  4. 4.Department of Endocrinology, Jiangsu Province HospitalThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
  5. 5.Department of Epidemiology and BiostatisticsNanjing Medical University School of Public HealthNanjingChina
  6. 6.Division of Experimental Medicine, Department of Medicine, Haematology Research CentreImperial College LondonLondonUK

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