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Baseline anti-HBc positivity does not impact 3-year PFS or OS in HBsAg-negative DLBCLHepatitis B history does not impact lymphoma treatment outcomes

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Key Takeaway
Note that baseline anti-HBc positivity does not impact 3-year PFS or OS in HBsAg-negative DLBCL patients.

This supplementary analysis evaluated 405 patients with HBsAg-negative diffuse large B-cell lymphoma (DLBCL) receiving rituximab-containing CHOP-based therapy. The study compared patients with baseline anti-HBc positivity (indicating resolved hepatitis B virus infection) against those with anti-HBc negativity.

Primary outcomes included 3-year progression-free survival (PFS) and 3-year overall survival (OS). The 3-year PFS was 78% in the anti-HBc-positive group versus 81% in the anti-HBc-negative group. The 3-year OS was 90% in both the anti-HBc-positive and anti-HBc-negative groups. No statistically significant differences were observed between the two groups for either PFS or OS.

Safety data noted the occurrence of HBV reactivation as an adverse event. A notable limitation is that this is a supplementary analysis of a trial that already showed no improvement in PFS with dose-dense rituximab plus CHOP. The results indicate that baseline anti-HBc positivity was not associated with inferior outcomes in this population. Clinical application should be interpreted with caution due to the nature of the analysis.

How this fits prior evidence

How this fits prior evidence: This finding addresses a gap in clinical data regarding the impact of prior hepatitis B infection on outcomes in DLBCL patients. While previous coverage noted that HBeAg positivity and high HBV DNA levels increase postpartum ALT elevation risk in chronic hepatitis B, this study specifically confirms that anti-HBc status does not impact 3-year PFS or OS in HBsAg-negative DLBCL patients treated with rituximab-containing CHOP-based therapy.

When doctors treat patients with diffuse large B-cell lymphoma, they must consider the patient's past health history. One specific concern is whether a previous hepatitis B infection affects how well a standard chemotherapy and antibody treatment works. This study looked specifically at patients who were currently clear of the hepatitis B virus but had evidence of a past infection.

The researchers looked at 405 patients treated with a standard regimen called rituximab-containing CHOP. They compared those with a positive marker for past hepatitis B against those without it. The results showed that both groups had the same three-year progression-free survival rates. They also had identical overall survival rates at the three-year mark.

While the study was a supplementary analysis of an existing trial, it provides some clarity for doctors. It suggests that having a past hepatitis B infection does not lead to worse outcomes for these specific lymphoma patients. Because the data comes from a supplementary analysis, it is important to discuss these specific results with a medical team.

What this means for you:
A history of hepatitis B does not appear to change survival outcomes for patients with this specific lymphoma.

Common questions

Does a history of hepatitis B make lymphoma treatment less effective?

No, the study found that patients with a history of hepatitis B (anti-HBc positive) had the same survival rates as those without it. Both groups showed a 90% overall survival rate at three years. This means the past infection did not make the current treatment less effective for these patients.

What were the survival rates for these patients?

The study followed 405 patients for 36 months. Both groups—those with a history of hepatitis B and those without—showed a 90% overall survival rate. Additionally, the progression-free survival rate was very similar between the two groups, at 78% and 81% respectively.

Is it safe for patients with past hepatitis B to receive this treatment?

The study included a note regarding hepatitis B virus reactivation as a potential event. However, the results showed no significant difference in outcomes between the two groups. You should always discuss your specific medical history and the risks of treatment with your doctor.

Study Details

Study typeRct
Sample sizen = 405
EvidenceLevel 2
Follow-up36.0 mo
PublishedNov 2026
View Original Abstract ↓
The impact of resolved hepatitis B virus (HBV) infection, defined as pretreatment hepatitis B surface antigen (HBsAg) negativity with antibody to hepatitis B core antigen (anti-HBc) positivity, on the clinical characteristics and outcomes of diffuse large B-cell lymphoma (DLBCL) remains unclear. JCOG0601 was a randomized phase II/III trial showing no improvement in progression-free survival (PFS) with dose-dense rituximab plus CHOP in previously untreated DLBCL. This supplementary analysis of JCOG0601 evaluated whether baseline anti-HBc positivity affects PFS and overall survival (OS) in patients with HBsAg-negative DLBCL treated with rituximab-containing CHOP-based therapy. Among 406 eligible patients randomly assigned in JCOG0601, 405 with available baseline HBV serologic data were included. Baseline characteristics and outcomes were compared according to anti-HBc status. Of the 405 patients, 87 were anti-HBc-positive and 318 were anti-HBc-negative. Anti-HBc-positive patients were older than anti-HBc-negative patients (median age, 63 vs. 61 years; p = 0.008). No significant differences in PFS or OS were observed between the two groups (3-year PFS, 78% vs. 81%; 3-year OS, 90% vs. 90%). HBV reactivation occurred in five anti-HBc-positive patients. Baseline anti-HBc positivity was more common in older patients but was not associated with inferior outcomes in HBsAg-negative DLBCL treated with rituximab-containing CHOP-based therapy.Clinical trial registration: JCOG0601 was registered in the Japan Registry of Clinical Trials (jRCTs031180139, date of registration; February 20, 2019).
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