Worse outcome and distinct mutational pattern in follicular lymphoma with anti-HBc positivity

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Epidemiological studies have demonstrated the association between hepatitis B virus (HBV) infection and B-cell non–Hodgkin lymphoma (NHL), mainly for diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). We studied a cohort of 121 patients with FL for HBV infection status, clinical features, and gene mutational profile. Anti-HBc was detectable in 16 patients (13.2%), although all had undetectable HBV DNA. AntiHBcore1 (anti-HBc1) cases presented with older age at diagnosis than anti-HBc2 cases (68.1 vs 57.2 years; P 5 .007) and higher b2-microglobulin (56.3% vs 28.9%; P 5 .04). All patients included in the study fulfilled criteria for treatment and received therapy with rituximab or rituximab-containing chemotherapy. There were no episodes of HBV reactivation or HBV hepatitis during treatment and/or maintenance. Remarkably, anti-HBc1 patients had significantly lower 10-year progression-free survival (PFS; 12.9% vs 58.3%; P, .0001) and overall survival (OS; 22.0% vs 86.2%; P, .0001), that remained at multivariate analysis. Gene mutational profiling of all cases showed that anti-HBc1 cases had higher incidence of ARID1A mutations and absence of EP300 mutations, 2 key epigenetic regulators in FL. Overall, our study shows that FL patients with resolved HBV infection have a worse outcome independently of other well-known clinical risk factors and a distinct gene mutational profile.




Fernandez-Rodrıguez, C., Rodrıguez-Sevilla, J. J., Fernandez-Ibarrondo, L., Sanchez-Gonzalez, B., Gibert, J., Bento, L., … Salar, A. (2022). Worse outcome and distinct mutational pattern in follicular lymphoma with anti-HBc positivity. Blood Advances, 6(1), 82–86. https://doi.org/10.1182/bloodadvances.2021005316

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