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The prognostic role of HBV infection in chronic lymphocytic leukemia

  • Original Article – Cancer Research
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

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).

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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).

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Author notes

  1. Jin-Hua Liang, Rui Gao and Jun-Cheng Dai are contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China

    Jin-Hua Liang, Wang Li, Lei Fan, Wei Xu & Jian-Yong Li

  2. Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China

    Jin-Hua Liang, Wang Li, Lei Fan, Wei Xu & Jian-Yong Li

  3. Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China

    Jin-Hua Liang, Wang Li, Lei Fan, Wei Xu & Jian-Yong Li

  4. Department of Endocrinology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China

    Rui Gao

  5. Department of Epidemiology and Biostatistics, Nanjing Medical University School of Public Health, Nanjing, 210029, China

    Jun-Cheng Dai & Zhi-Bin Hu

  6. Division of Experimental Medicine, Department of Medicine, Haematology Research Centre, Imperial College London, London, UK

    Robert Peter Gale

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  1. Jin-Hua Liang
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  2. Rui Gao
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  8. Wei Xu
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Correspondence to Wei Xu or Jian-Yong Li.

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Liang, JH., Gao, R., Dai, JC. et al. The prognostic role of HBV infection in chronic lymphocytic leukemia. J Cancer Res Clin Oncol 144, 1309–1315 (2018). https://doi.org/10.1007/s00432-018-2663-z

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  • DOI: https://doi.org/10.1007/s00432-018-2663-z

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