PURPOSE:A phase 3 trial has shown that high-dose, accelerated, hyperfractionated, twice-daily thoracic radiation therapy (54 Gy in 30 fractions) is clinically effective for patients aged <70 years with limited-stage small cell lung cancer (LS-SCLC). This retrospective study compares the real-world effectiveness of high-dose hyperfractionated simultaneous integrated boost radiation therapy with standard-dose radiation therapy. METHODS AND MATERIALS:This retrospective study was conducted at Peking University Cancer Hospital, including patients with histologically or cytologically confirmed LS-SCLC. All eligible patients received 4 courses of thoracic radiation therapy combined with concurrent chemotherapy (cisplatin or carboplatin and etoposide). Patients were categorized into 3 groups based on the radiation therapy dose: (1) the 54 Gy group (54 Gy in 30 fractions, twice daily); (2) the 45 Gy group (45 Gy in 30 fractions, twice daily); and (3) the 60 Gy group (60-70 Gy in 30-35 fractions, once daily). The primary endpoints were real-world progression-free survival and overall survival. RESULTS:Between March 2010 and November 2024, a total of 353 patients were included in the study. The median follow-up was 54.9 months (range, 2.9-151.6 months). After applying inverse probability of treatment weighting (IPTW), the clinical features were well balanced between the groups. The median real-world progression-free survival was significantly better in the 54 Gy group (29.7 months [95% CI, 15.9-not reached]) compared with the 45 Gy group (15.0 months [95% CI, 11.8-30.4]; hazard ratio [HR], 1.23 [95% CI, 1.01-1.50]) and the 60 Gy group (13.5 months [95% CI, 11.4-15.9]; HR, 1.29 [95% CI, 1.09-1.54]) both before (P = .011) and after (P = .033) IPTW. The median overall survival was also significantly longer in the 54 Gy group (63.9 months [95% CI, 57.1-not reached]) compared with the 45 Gy group (42.9 months [95% CI, 32.3-70.8]; HR, 1.76 [95% CI, 1.19-2.61]) and the 60 Gy group (38.0 months [95% CI, 30.8-51.9]; HR, 1.60 [95% CI, 1.05-2.44]) both before (P = .015) and after (P = .006) IPTW. Treatment-related toxicities were similar across the 3 groups. CONCLUSIONS:High-dose, accelerated, hyperfractionated, twice-daily thoracic radiation therapy (54 Gy) was well tolerated and effective in this large, real-world cohort study of patients with LS-SCLC compared with standard-dose (45 Gy twice daily and 60-70 Gy every day) radiation therapy.

Diffuse large B-cell lymphoma (DLBCL) patients with co-expression of MYC (≥ 40

Hepatocellular carcinoma (HCC) remains one of the most prevalent and lethal cancers globally. While surgical resection and liver transplantation offer potential cures for early-stage HCC, the majority of patients are diagnosed at advanced stages where such interventions are not viable. Sorafenib, a multi-target kinase inhibitor, has been a cornerstone in the treatment of advanced HCC since its approval in 2007. Despite its significant clinical impact, less than half of the treated patients derive long-term benefits due to the emergence of resistance and associated side effects. This review focuses on the role of sorafenib, an FDA-approved multi-target kinase inhibitor, in treating advanced HCC, discusses the mechanisms underlying its therapeutic effects and associated resistance, and explores additional therapeutic strategies being investigated to improve patient outcomes.

Sovleplenib (HMPL-523) is a selective spleen tyrosine kinase (Syk) inhibitor with anti-tumor activity in preclinical models of B-cell malignancy. We conducted a dose-escalation and dose-expansion phase I study of sovleplenib in patients with relapsed/ refractory mature B-cell tumors. Dose escalation followed a 3+3 design; patients received oral sovleplenib (200-800 mg once daily [q.d.] or 200 mg twice daily [b.i.d.], 28-day cycles). During dose expansion, patients were enrolled into four cohorts per lymphoma classification and treated at the recommended phase II dose (RP2D) (clinicaltrials gov. Identifier: NCT02857998). Overall, 134 Chinese patients were enrolled (dose escalation, N=27; dose expansion, N=107). Five patients experienced dose-limiting toxicities: one each of amylase increased (200 mg q.d.), febrile neutropenia (800 mg q.d.), renal failure (800 mg q.d.), hyperuricemia and blood creatine phosphokinase increased (200 mg b.i.d.) and blood bilirubin increased and pneumonia (200 mg b.i.d.). RP2D was determined as 600 mg (>65 kg) or 400 mg (≤65 kg) q.d.. The primary efficacy end point of independent review committee-assessed objective response rate in indolent B-cell lymphoma was 50.8% (95% confidence interval: 37.5- 64.1) in 59 evaluable patients at RP2D (follicular lymphoma: 60.5%, marginal zone lymphoma: 28.6%, lymphoplasmacytic lymphoma/Waldenström macroglobulinemia, 0%). The most common (≥10% patients) grade ≥3 treatment-related adverse events in the dose-expansion phase were decreased neutrophil count (29.9%), pneumonia (12.1%) and decreased white blood cell count (11.2%). Pharmacokinetic exposures increased dose-proportionally with ascending dose levels from 200-800 mg, without observed saturation. Sovleplenib showed anti-tumor activity in relapsed/refractory B-cell lymphoma with acceptable safety. Further studies are warranted.

BackgroundCerebral radiation necrosis (RN), a severe complication of stereotactic radiotherapy (SRT), has been shown to significantly decrease patient survival time and quality of life. The purpose of this study was to analyze whether bevacizumab can prevent or reduce the occurrence of SRT-induced cerebral RN in non-small cell lung cancer (NSCLC) patients with brain metastases.Materials and methodsWe retrospectively reviewed the clinical records of NSCLC patients with brain metastases from March 2013 to June 2023 who were treated with SRT. Patients were divided into two groups: those in the bevacizumab group received SRT with four cycles of bevacizumab, and patients in the control group received SRT only. Inverse probability of treatment weighting (IPTW) was performed based on a multinomial propensity score model to balance the baseline characteristics. The chi-square test was used. A Cox model was used to evaluate overall survival (OS).ResultsA total of 80 patients were enrolled, namely, 28 patients in the bevacizumab group and 52 patients in the control group. The possibility of developing cerebral RN and/or symptomatic edema (RN/SE) was significantly decreased in patients treated with bevacizumab compared to those who did not receive bevacizumab before IPTW (p=0.036) and after IPTW (p=0.015) according to chi-square analysis. The IPTW-adjusted median OS was 47.7 months (95% CI 27.4-80.8) for patients in the bevacizumab group and 44.1 months (95% CI 36.7-68.0) (p=0.364) for patients in the control group.ConclusionThe application of bevacizumab concurrent with SRT may prevent or reduce the occurrence of cerebral RN in NSCLC patients with brain metastases.

Background This study aimed to compare the efficacy and safety of high-dose methotrexate (HD-MTX) versus teniposide (TEN) in patients with newly diagnosed immunocompetent primary central nervous system lymphomas (PCNSLs). Methods The study included immunocompetent, adult patients with newly diagnosed PCNSL at 22 centers in China from 2007 to 2016. The patients received HD-MTX or TEN as first-line induction therapy. The objective response rate, progression-free survival, and overall survival were analyzed for each patient cohort. Results A total of 96 patients were eligible: 62 received HD-MTX, while 34 received teniposide. The overall response rate was 73.2% and 72.7% in the MTX and the TEN cohorts, respectively ( P = 0.627). The median progression-free survival was 28.4 months [95% confidence interval (CI): 13.7–51.2] in the MTX cohort and 24.3 months (95% CI: 16.6–32.1) in the TEN cohort ( P = 0.75). The median overall survival was 31 months (95% CI: 26.8–35.2) in the MTX cohort and 32 months (95% CI: 27.6–36.4) in the TEN cohort ( P = 0.77). The incidence of any grade of coagulopathy/deep-vein thrombosis and gastrointestinal disorders was significantly higher in the MTX cohort than in the TEN cohort; no significant difference was found in the incidence of other adverse events between the two cohorts. Conclusions This was the first multicenter study using TEN as the main agent compared with HD-MTX in newly diagnosed primary CNS lymphoma. The TEN-based regimen was non-inferior to the HD-MTX-based regimen with similar overall responses. Classification of evidence This study provided Class III evidence that the teniposide-based regimen was non-inferior to high-dose methotrexate − based regimen with similar overall responses and long-time survival in immunocompetent patients with PCNSL.

OBJECTIVE:To analyze the clinical characteristics and long-term prognosis of patients with primary bone lymphoma (PBL).METHODS:The clinical data of 21 patients with PBL treated in our center from 2005 to 2018 were analyzed retrospectively, the clinical characteristics and the factors affecting prognosis of the patients were analyzed.RESULTS:The median age of all the 21 newly diagnosed PBL patients was 40(12-71) years old. Ostealgia was the initial symptom in most of the patients (19/21,90.5%). 42.9%(9/21) of the patients showed single bone lesion only. 571% (12/21) of the patients showed diffuse large B cell lymphoma. 28.6% (6/21) of the patients showed anaplastic large cell lymphoma and 9.5% (2/21) of the patients showed T cell lymphoblastic lymphoma. All the patients received chemotherapy (CHOP or CHOP like regimen, 33.3% plus rituximab) with or without radiotherapy and/or autologous hematopoietic stem cell transplantation (ASCT). 18 patients achieved clinical remission (including 15 for CR and 3 for PR). The median follow-up time was 48 months. The 5-year overall survival rate and progression-free survival rate of the patients were was 67.5% and 63.7%, respectively. The single factors analysis showed that ASCT was the important prognostic factor of PFS, while the single or multiple bone lesion was the factors affecting OS of the patients. There were no statistical differences with the effects of age, sex, stage, ECOG score, LDH level, B symptoms and radiotherapy for the prognosis of patients.CONCLUSION:Diffuse large B cell lymphoma is the most common pathological type of PBL. Chemotherapy is the main treatment, which can be combined with radiotherapy and/or ASCT. The ASCT and the number of bone lesion are the factors for long time survival of the patients.

Background: A novel glycoengineered type II anti-CD20 antibody, MIL62 with a nearly completely afucosylated N-glycans in Fc region, has demonstrated superior activity compared with rituximab and obinutuzumab in vitro and in vivo, respectively. Orelabrutinib (ICP-022) is a novel and highly selective irreversible Bruton's tyrosine kinase (BTK) inhibitor that does not affect IL2-associated tyrosine kinase (ITK) or antibody-dependent cellular cytotoxicity, making it an attractive candidate for combined therapy with anti-CD20 antibodies. Methods: This was a phase I/IIa dose escalation and dose expansion study (NCT 04304040), which investigated MIL62 combination with orelabrutinib for the treatment of patients with relapsed/refractory (r/r) B-cell non-Hodgkin lymphoma (B-NHL) with received at least one prior systemic regimen. The dose escalation was conducted with a standard 3+3 dose scheme in different dose combinations of MIL62 injection 800 mg or 1000 mg plus orelabrutinib 100 mg or 150 mg oral daily up to 120 weeks or until disease progression, or intolerable toxicity, respectively. The primary endpoint was objective response rate (ORR), defined as a complete response (CR) or partial response (PR) assessed by investigator per Lugano 2014 criteria. The secondary endpoints were duration of response, pharmacokinetics, and safety. Adverse events (AEs) were graded by CTCAE version 5.0. Results: From July 28th, 2020 to January 26th, 2022, 43 patients enrolled from 10 centers in China received at least one dose of either MIL62 or orelabrutinib. Diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), mantle cell lymphoma (MCL) and marginal zone lymphoma (MZL) accounted for 72.1% (31), 16.3% (7), 9.3% (4) and 2.3% (1), respectively. Median age was 66.0 (range: 31 to 77) years and 29 (67.5%) patients had ECOG PS score of 1-2. The median number of prior therapies was 2.0 (range: 1 to 7) and 22 (51.2%) patients were primary resistant to rituximab-containing regimens. The median treatment time of MIL62 and orelabrutinib was 4.7 (range: 0.2, 17.5) months and 3.9 (range: 0.2, 14.1) months, respectively. At the cut-off date (July 15th, 2022), the median OS follow-up time was 13.0 (95% confidence interval [95% CI]: 12.2, 15.0) months. Overall, 27 (64.3%) of 42 assessable patients had an objective response, including 13 (31%) with CR and 14 (33.3%) with PR. In addition, among 30 assessable patients with DLBCL, 17 (56.7%) patients had an objective response, including 7 (23.3%) with CR and 10 (33.3%) with PR. The median progression-free survival (PFS), 9-month remission rate and 12-month overall survival rate were 5.8 ([95%CI]: 3.9, Not reached) months, 71.4%, 73.0%, respectively. Especially, in 20 patients with resistance to rituximab, 10 (50%) patients had an objective response, and median PFS was 5.6 months (Table 1). Among 43 safety-evaluable patients, treatment emergent adverse events (TEAEs) and treatment-related adverse events (TRAEs) occurred in 39 (90.7%) patients, 38 (88.4%) patients respectively. Grade 3 or above TEAE were observed in 20 (46.5%) patients, among which TRAEs in 16 (37.2%) patients, with neutropenia (20.9%), thrombocytopenia (16.3%). Severe adverse events (SAEs) occurred in 14 (32.6%) patients, among which 11 (25.6%) were TRAEs. 4 (9.3%) patients were permanently stopped the study due to TEAEs. The incidence of MIL62 infusion-related reactions was 11.6%, all of which were grade 1-2. Conclusion: MIL62 combined with orelabrutinib showed promising efficacy in previously treated patients with r/r DLBCL, including those with resistance to rituximab, and has a manageable safety profile. Keywords: MIL62; type II anti-CD20 monoclonal antibody; r/r B-NHL; DLBCL; Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Prostate androgen-regulated mucin-like protein (PARM1) is known to promote cell survival via protecting the cell surface, thus being involved in cancer development. The Gene Expression Profiling Interactive Analysis (GEPIA), MEXPRESS database, LinkedOmics database, GeneMANIA database, and the Tumor Immune Estimation Resource (TIMER) database were accessed to explore the epigenetic regulation, prognostic value, biological functions and mechanisms of PARM1 in diffuse large B-cell lymphoma (DLBCL). Hypomethylation and resultant overexpression of PARM1 was found in DLBCL. The high-level expression of PARM1 was related to the poor outcome of DLBCL patients. PARM1 participated in DNA repair, cell cycle, and cellular response to stress. PARM1 was also associated with autophagy, apoptosis, Ras pathway, and MAPK cascade. Significant kinase targets of PARM1 included ATM, CDK1, and CDK2. Significant transcription factor targets of PARM1 involved ELK1, MYC and so on. Significant miRNA targets of PARM1 included miR21, miR202, miR323, and miR345. Further analysis suggested that the PARM1 regulated autophagy through the PI3K-Akt signaling. PARM1 was found to be correlated with immune cell infiltration, which indicated the important roles of PARM1 in microenvironment of DLBCL. Our study lays a foundation for further research on the impact of PARM1 in DLBCL tumorigenesis and precision therapy.

目的 评估18氟-氟代脱氧葡萄糖-正电子发射计算机断层显像/电子计算机断层扫描(18 F-flurodeoxyglucose positron emission tomography/computed tomography,18 F-FDG PET/CT)的最大标准化摄取值(maximum standard uptake value,SUVmax)与B细胞非霍奇金淋巴瘤的疗效及预后的关系.方法 分析2016年8月至2019年9月于首都医科大学附属北京世纪坛医院收治的初治弥漫大B细胞淋巴瘤及滤泡性淋巴瘤患者共47例,评估基线SUVmax与各临床病理因素、实验室化验指标之间的相关性,用受试者工作特征(receiver operating characteristic,ROC)曲线分析法确定基线SUVmax对疾病进展的最佳临界点,分析其对治疗疗效及生存的预后、预测价值.结果 ①乳酸脱氢酶(lactic dehydrogenase,LDH)浓度、1年内有无进展、病理类型组别中的基线SUVmax均值差异有统计学意义;②以1年进展率为截点,ROC曲线上SUVmax最佳临界点为14.4,以14.4为界限值进行分组,发现SUVmax<14.4组患者中位无进展生存时间(progression-free survival,PFS)、中位总生存期(overall survival,OS)均远远高于SUVmax≥14.4组;③以随访结束后患者疾病进展为截点,SUVmax最佳临界点为16.7,以16.7为界限值进行分组,发现SUVmax<16.7组患者中位PFS远高于SUVmax≥16.7组(P=0.025).结论 B细胞型非霍奇金淋巴瘤患者的基线SUVmax与疗效及生存预后有密切关系,具有很大的临床应用价值.

Cadherin-23(CDH23) mediates homotypic and heterotypic cell-cell adhesions in cancer cells. However, the epigenetic regulation, the biological functions, the mechanisms and the prognostic value of CDH23 in diffuse large B-cell lymphoma (DLBCL) are still unclear. The Gene Expression Profiling Interactive Analysis (GEPIA) and the Gene Expression Omnibus (GEO) database were employed to analyze the CDH23 expression level in DLBCL. The correlation of CDH23 expression and methylation was analyzed by LinkedOmics database. The prognostic value was analyzed via GEPIA. Correlated genes, target kinase, target miRNA, target transcription factor and biological functions were identified by LinkedOmics and GeneMANIA database. The relationship between CDH23 and the immune cell infiltration was explored by the Tumor Immune Estimation Resource (TIMER). The expression of CDH23 was reduced by DNA methylation significantly in DLBCL tissue. Reduction of CDH23 represented poor outcome of DLBCL patients. Functional enrichment analysis showed that CDH23 mainly enriched in cancer cell growth, cell metastasis, cell adhesion, cell cycle, drug catabolic process, leukocyte mediated immunity and DNA repair by some cancer related kinases, miRNAs and transcription factors. These results indicated that methylated reduction of CDH23 represented poor outcome of DLBCL. CDH23 is associated with essential biological functions and key molecules in DLBCL. CDH23 may play crucial roles in DLBCL tumorigenesis. Our results lay a foundation for further investigation of the role of CDH23 in DLBCL tumorigenesis.

目的 评估基线18 F-FDG PET/CT参数:SUVmax、MTV、TLG对RCHOP初治的DLBCL患者的疗效及生存预后价值.方法 回顾性分析我科初治的、接受RCHOP方案治疗的DLBCL患者20例,分析基线SUVmax、MTV、TLG与各临床病理因素、实验室化验指标之间的相关性,用ROC曲线分析法确定基线SUVmax、MTV、TLG最佳临界点,分析其对疗效及生存预后的预测价值.结果(1)Ⅰ/Ⅱ期患者基线SUVmax均值远低于Ⅲ/Ⅳ期患者,有无B症状、IPI危险分层等不同因素的MTV均值差别较大,Ann Arbor分期、ECOG评分、LDH水平、结外受侵个数、IPI危险分层等不同因素的TLG均值差别较大,差异均具有统计学意义;(2)MTV<365.5组患者中位PFS优于MTV≥365.5组患者,TLG<2464.02组患者中位PFS优于TLG≥2464.02组患者,差异有统计学意义;(3)年龄≤60岁、无B症状、Ⅰ/Ⅱ期患者、血红蛋白≥120g/L中位PFS相对较高,差异具有统计学意义.结论 DLBCL患者的基线MTV、TLG与疗效及生存预后有密切关系,值得进一步研究和临床探索.

Objective:To explore the therapeutic effects and adverse reactions of the liposomal doxorubicin-based regimens in the treatment of adult patients with T-cell lymphoma.Methods:The clinical data of patients with T-cell lymphoma who were diagnosed and treated in Beijing Shijitan Hospital of Capital Medical University from August 2012 to May 2016 was retrospectively analyzed. All patients received chemotherapy containing liposomal doxorubicin. The clinical manifestations, treatment results, and adverse reactions were observed.Results:A total of 16 patients were enrolled, with a median age of 50.5 years old (16-81 years old), of which 7 patients were newly treated and 9 patients were retreated (including 5 refractory patients). Eleven of the 16 patients were evaluated for efficacy, including 4 cases of complete remission (CR) and 4 cases of partial remission (PR), the overall response rate was 72.8% (8/11). With a median follow-up of 11 months, the 2-year progression-free survival rate and overall survival rate were 42.4% and 41.6%. All 5 primary skin T-cell lymphoma patients were refractory or relapsed with 1 case of CR and 4 cases of PR after treatment. The adverse reactions were acceptable.Conclusions:The remission rate of liposomal doxorubicin-based regimens for treatment of adult patients with T-cell lymphoma is promising, especially for newly-treated patients. Primary skin T-cell lymphoma patients might be more likely to benefit from liposomal doxorubicin-based regimens.

OBJECTIVE:To study the regulatory effect of deubiquitinase MYSM1 on differentiation of B cells to plasma cells.METHODS:The interfering and overexpression plasmids of MYSM1 were constructed and then the corresponding lentiviruses were packaged. Human CD19+ B cells were isolated from human peripheral blood with Miltenyi B cell isolation kit. Purified CD19+ B cells were transduced with lentiviruses and then treated with LPS, the CD138 expression was detected by flow cytometry. The expression of transcription factor was determined by quantitative PCR.RESULTS:The differentiation of B cells to plasma cells was enhanced after interfering in MYSM1 expression. Quantitative PCR showed that mRNA levels of Pax5 and Bach2 in cells with interfering in MYSM1 were much lower than their counterpart (P＜0.01), and mRNA levels of Prdm1 and Xbp1 in cells with interfering in MYSM1 were much higher than their counterpart (P＜0.01). On the contrary, the differentiation of B cells to plasma cells was inhibited after the overexpression of MYSM1. Quantitative PCR showed that mRNA levels of Pax5 and Bach2 in cells with MYSM1 overexpression were higher than those in control cells (P＜0.01), and mRNA levels of Prdm1 and Xbp1 in cells with MYSM1 overexpression were much lower than those in their counterpart (P＜0.01).CONCLUSION:MYSM1 negatively regulates differentiation of human B cells to plasma cells.

The combination of chemotherapy and L-asparaginase (L-ASP) treatment significantly increased survival rate in an adult patient with extranodal natural killer (NK)/T-cell lymphoma (NKTCL). However, hypersensitivity reactions of L-ASP in some patients limited its application. Polyethylene glycol-conjugated asparaginase (PEG-ASP) has a lower immunogenicity and longer circulating half-life than unconjugated L-ASP, and has been reported to be effective and well-tolerated in children with acute lymphoblastic leukemia. Cyclophosphamide, hydroxydaunorubicin (doxorubicin), oncovin (vincristine), and prednisolone (CHOP) is the most common chemotherapy for non-Hodgkin lymphoma. In this report, we sought to study the efficacy and safety of PEG-L- CHOP in NKTCL in adult Chinese patients.

Background: Prospective real-life data on the safety and effectiveness of rituximab in Chinese patients with diffuse large B-cell lymphoma (DLBCL) or follicular lymphoma (FL) are limited. This real-world study aimed to evaluate long-term safety and effectiveness outcomes of rituximab plus chemotherapy (R-chemo) as first-line treatment in Chinese patients with DLBCL or FL. Hepatitis B virus (HBV) reactivation management was also investigated. Methods: A prospective, multicenter, single-arm, noninterventional study of previously untreated CD20-positive DLBCL or FL patients receiving first-line R-chemo treatment at 24 centers in China was conducted between January 17, 2011 and October 31, 2016. Enrolled patients underwent safety and effectiveness assessments after the last rituximab dose and were followed up for 3 years. Effectiveness endpoints included progression-free survival (PFS) and overall survival (OS). Safety endpoints were adverse events (AEs), serious AEs, drug-related AEs, and AEs of special interest. We also reported data on the incidence of HBV reactivation. Results: In total, 283 previously untreated CD20-positive DLBCL and 31 FL patients from 24 centers were enrolled. Three-year PFS was 59% (95% confidence interval [CI]: 50–67%) for DLBCL patients and 46% (95% CI: 20–69%) for FL patients. For DLBCL patients, multivariate analyses showed that PFS was not associated with international prognostic index, tumor maximum diameter, HBV infection status, or number of rituximab treatment cycles, and OS was only associated with age >60 years (P < 0.05). R-chemo was well tolerated. The incidence of HBV reactivation in hepatitis B surface antigen (HBsAg)-positive and HBsAg-negative/hepatitis B core antibody-positive patients was 13% (3/24) and 4% (3/69), respectively. Conclusions: R-chemo is effective and safe in real-world clinical practice as first-line treatment for DLBCL and FL in China, and that HBV reactivation during R-chemo is manageable with preventive measures and treatment. Trial Registration: ClinicalTrials.gov, NCT01340443; https://clinicaltrials.gov/ct2/show/NCT01340443.

Background: Due to the high rate of chronic hepatitis B virus (HBV) infection in China, hepatitis B surface antigen (HBsAg) can be detected among 25-61% of patients with diffuse large B-cell lymphoma (DLBCL) and 20-40% with follicular lymphoma (FL), while HBsAg- negative (neg) /HBcAb-positive (pos) can be detected among 20-44% of patients with DLBCL (Chinese Society of Hematology, 2013). When these patients receive immune-suppressing treatment, they are at an increased risk of HBV reactivation which may lead to hepatic mortality and interrupt the rituximab-based chemotherapy. For patients and their physicians, HBV infection management plays a crucial role for achieving optimal survival outcomes without compromising safety. This multicenter, single-arm, prospective, non-interventional study was conducted at 24 centers in China between January 17, 2011 and October 31, 2016. Previously untreated CD20-positive DLBCL patients who were eligible to receive rituximab plus chemotherapy (R-chemo) (CHOP or non-CHOP) as first-line treatment were enrolled with no specific exclusion criteria. We investigated the risk of HBV reactivation in patients with CD20+ DLBCL or FL which received R-chemo as first-line treatment. Methods: Patients who received at least one dose of R-chemo were included in the analysis. Data were collected and analyzed from medical records for 3 years since the last R dose was administered. The evaluation of HBV infection management included HBV infection and liver function screening before R-chemo, viral replication monitoring during and after R-chemo, antiviral prophylaxis use and HBV reactivation rates. HBsAg-pos patients had HBV reactivation if HBV DNA increased ≥1 log10 from baseline, if HBV DNA appeared (above the lower limit of detection) or if HBeAg appeared in HBeAg- neg patients. HBsAg-neg/HBcAb-pos patients had HBV reactivation if there was appearance of either HBsAg or HBV DNA (above the lower limit of detection). The HBV reactivation was determined by SAP and investigator9s judgment. This study was registered in clincialtrials.gov (NCT01340443). Results: In total, 282 DLBCL patients and 31FL patients were included in the analysis. HBV screening data were available from 271 enrolled patients. At baseline, 26 patients were HBsAg-pos, 79 were HBsAg- neg/HBcAb-pos and 166 were double neg. HBV infection status was undefined for 42 patients. During the study, HBV reactivation was detected in 8 patients, which was only in the DLBCL group. Seven cases were observed in treatment period, while 1 case occurred during 3-year follow-up. None of them led to study termination, temporary termination, or dose adjustment. Cox univariate regression analysis in DLBCL patients showed that baseline type of hepatitis B correlated with overall response rate (ORR) and complete response (CR) but had no effect on progression-free survival (PFS). In term of HBV infection management, in DLBCL group, 25 patients with HBsAg-pos or HBsAg-neg/ HBcAb-pos receiving antiviral prophylaxis. In FL group, only 3 patients received antiviral treatment. Lamivudine was mostly administered by Chinese investigators. Details on treatment, duration and infection status are listed in Table 1. Summary: In this prospective, observational study, we followed the patients with DLBCL or FL for 3 years to investigate the risk of HBV reactivation after they received R-chemo. Our study showed that, in real-world setting, the incidence of HBV reactivation in patients with a history of hepatitis, particularly those positive for HBsAg is acceptable, baseline type of hepatitis B had no effect on PFS. Close monitoring and antiviral prophylaxis would be beneficial to the patients with DLBCL or FL combined with hepatitis B infection while they receive R-chemo. Disclosures No relevant conflicts of interest to declare.