Introduction:
While HBV-associated DLBCL exhibits distinct clinical characteristics and outcomes, the association between HBV infection and mature T-cell and NK-cell lymphomas (TNKLs) and its impact on outcomes remain unexplored.
Objectives:
To define the impact of HBV infection (HBV+, defined as prior exposure [HBVcAb positivity] or active infection [HBVsAg positivity]) on clinical characteristics and OS in TNKL patients across histological subtypes relative to patients without HBV infection (HBV-).
Methods:
Using the PETAL consortium's global retrospective cohort, 763 patients with R/R TNKLs who failed frontline therapy were included (85 HBV+, 399 HBV-, and 279 unknown). HBV serostatus was determined by HBVsAg or HBVcAb measurements at diagnosis. KM analysis and CPH models were used to assess the impact of HBV infection (HBV+ versus HBV-) on OS.
Results:
HBV infection was significantly associated with inferior OS (p=0.02). Subgroup analysis revealed a pronounced effect in PTCL-NOS (p=0.004) and ALCL (p=0.004), but not in AITL (p=0.6) or ENKTCL (p=0.6). In ALCL, the inferior outcome of HBV+ patients was observed after adjusting for statistically significant differences in baseline characteristics such as country, sex, race, absolute lymphocyte count, or 1st-line treatment.
Conclusions:
This study, leveraging the largest R/R TNKL global cohort, identifies HBV serostatus as a significant prognostic factor in R/R TNKLs, particularly in PTCL-NOS and ALCL. Prospective studies incorporating longitudinal measurements of HBV viremia throughout the disease course, will be needed to discern various states of prior exposure, immunization and active infection and their effects on clinical presentation, treatment toxicities, and outcomes along with genomic characterization of HBV-associated TNKLs.
