Gaps in Pre-rituximab Hepatitis B Screening

Abstract

The aim of the study was to evaluate the pretreatment workup of patients referred to our tertiary care center with low-grade lymphoma for compliance with National Comprehensive Cancer Network guidelines. This was a retrospective chart review. The study included all new patients with low-grade lymphoma who were diagnosed and treated at our center from January 1, 2005, to December 30, 2011. All the major facets of pretreatment workup were examined, including bone marrow biopsy, lactate dehydrogenase, hepatitis B screening, performance status of the patient, and diagnostic radiological studies. A total of 53 new patients were identified, of whom 36 (68%) had pretreatment workup and treatment at our center. The median age at diagnosis was 67. Fifty-four percent of the patients had bone marrow biopsy done. Radiological diagnostic studies were conducted in 97% of the patients. Hepatitis B screening was done in 19% of the total patients and 25% of the patients who received rituximab. Lactate dehydrogenase levels were checked in 72% of the patients. A significant deviation from the National Comprehensive Cancer Network guidelines for low-grade lymphoma pretreatment workup was observed for hepatitis B screening. Measures to ensure that patients have hepatitis B screening before rituximab were implemented. Studies such as these help to improve patient care.