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Study to Evaluate Efficacy and Safety of Switching From TDF to TAF in Adults With Chronic Hepatitis B Who Are Virologically Suppressed

2020年8月24日 更新者:Gilead Sciences

A Phase 3, Randomized, Double-Blind Study to Evaluate the Efficacy and Safety of Switching From Tenofovir Disoproxil Fumarate (TDF) 300 mg QD to Tenofovir Alafenamide (TAF) 25 mg QD in Subjects With Chronic Hepatitis B Who Are Virologically Suppressed

The primary objectives of this study are to evaluate the efficacy, safety, and tolerability of switching to tenofovir alafenamide (TAF) versus continuing tenofovir disoproxil fumarate (TDF) in virologically suppressed adults with chronic hepatitis B virus (HBV) infection.

研究概览

研究类型

介入性

注册 (实际的)

490

阶段

  • 第三阶段

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

      • Edmonton、加拿大
      • Toronto、加拿大
      • Vancouver、加拿大
      • Chiayi City、台湾、60002
      • Kaohsiung、台湾
      • Taipei City、台湾、10002
      • Daegu、大韩民国、700-721
      • Seoul、大韩民国
      • Seoul、大韩民国、135-710
      • Seoul、大韩民国、05505
      • Seoul、大韩民国、03722
      • Seoul、大韩民国、152-703
      • Seoul、大韩民国、06973
      • Seoul、大韩民国、03830
    • Gyeonggi-d
      • Goyang、Gyeonggi-d、大韩民国
      • Milan、意大利、20122
    • California
      • Los Angeles、California、美国
      • Palo Alto、California、美国
      • Pasadena、California、美国
      • San Diego、California、美国
      • San Francisco、California、美国
      • San Jose、California、美国
    • Maryland
      • Baltimore、Maryland、美国
    • Massachusetts
      • Boston、Massachusetts、美国
    • Michigan
      • Novi、Michigan、美国
    • New York
      • Flushing、New York、美国
      • Flushing、New York、美国、11355
      • New York、New York、美国
      • New York、New York、美国、10029
    • Pennsylvania
      • Philadelphia、Pennsylvania、美国
      • Philadelphia、Pennsylvania、美国、19107
    • Tennessee
      • Nashville、Tennessee、美国
    • Texas
      • Sugar Land、Texas、美国、77478
      • London、英国
      • London、英国、E1 1BB
      • Barcelona、西班牙
      • Majadahonda、西班牙
      • Hong Kong、香港
      • Kowloon、香港

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

有资格学习的性别

全部

描述

Key Inclusion Criteria:

  • Must have the ability to understand and sign a written informed consent form; consent must be obtained prior to initiation of study procedures
  • Adult male and non-pregnant, non-lactating females
  • Documented evidence of chronic hepatitis B virus (HBV) infection previously
  • Maintained on tenofovir disoproxil fumarate (TDF) 300 mg once daily for at least 48 weeks, and as monotherapy for chronic hepatitis B for at least 24 weeks with viral suppression (HBV DNA < lower limit of quantitation) for a minimum of 12 weeks prior to screening
  • Adequate renal function
  • Normal Electrocardiogram

Key Exclusion Criteria:

  • Pregnant women or women who are breastfeeding
  • Males and females of reproductive potential who are unwilling to use an "effective", protocol-specified method(s) of contraception during the study.
  • Co-infection with hepatitis C virus (HCV), hepatitis D virus (HDV), or human immunodeficiency virus (HIV)
  • Evidence of hepatocellular carcinoma
  • Current evidence of, or recent (≤ 5 year) history of clinical hepatic decompensation
  • Abnormal hematological and biochemical parameters, including:

    • Hemoglobin < 10 g/dL
    • Absolute neutrophil count < 750/mm^3
    • Platelets ≤ 50,000/mm^3
    • Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 5 × upper limit of the normal (ULN)
    • Albumin < 3.0 mg/ dL
    • International normalized ratio (INR) > 1.5 × ULN (unless stable on anticoagulant regimen)
    • Total bilirubin > 2.5 × ULN
  • Received solid organ or bone marrow transplant
  • Malignancy within 5 years prior to screening, with the exception of specific cancers that are cured by surgical resection (eg, basal cell skin cancer). Individuals under evaluation for possible malignancy are not eligible.
  • Currently receiving therapy with immunomodulators (eg, corticosteroids), nephrotoxic agents, or agents capable of modifying renal excretion
  • Individuals receiving ongoing therapy with drugs not to be used with TAF or TDF or individuals with a known hypersensitivity to study drugs, metabolites, or formulation excipients
  • Current alcohol or substance abuse judged by the investigator to potentially interfere with compliance
  • Any other clinical condition or prior therapy that, in the opinion of the investigator, would make the individual unsuitable for the study or unable to comply with dosing requirements.
  • Use of investigational agents within 3 months of screening, unless allowed by the sponsor

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:随机化
  • 介入模型:并行分配
  • 屏蔽:双倍的

武器和干预

参与者组/臂
干预/治疗
实验性的:TAF 25 mg
Double-blind (DB) phase: TAF 25 mg + TDF placebo for up to 53 weeks. Open-label extension (OLE) phase: TAF 25 mg for up to 52 weeks.
每天口服一次 25 毫克片剂
其他名称:
  • Vemlidy®
  • GS-7340
每天一次口服片剂
有源比较器:TDF 300 mg
DB phase: TDF 300 mg + TAF placebo for up to 50 weeks. OLE phase: TAF 25 mg for up to 52 weeks.
每天口服一次 25 毫克片剂
其他名称:
  • Vemlidy®
  • GS-7340
每天口服一次 300 毫克片剂
其他名称:
  • 威瑞德®
每天一次口服片剂

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Percentage of Participants With Hepatitis B Virus (HBV) DNA Levels ≥ 20 IU/mL at Week 48, as Determined by the Modified United States Food and Drug Administration (US FDA)-Defined Snapshot Algorithm
大体时间:Week 48

The percentage of participants with HBV DNA ≥ 20 IU/mL at Week 48 was analyzed using the modified US FDA-defined snapshot algorithm, which included participants who:

  1. Had the last available on-treatment HBV DNA ≥ 20 IU/mL in the Week 48 analysis window (from Day 295 to Day 378, inclusive), or
  2. Did not have on-treatment HBV DNA data available in the Week 48 analysis window and

    • Discontinued study drug prior to or in the Week 48 analysis window due to lack of efficacy, or
    • Discontinued study drug prior to or in the Week 48 analysis window due to reason other than lack of efficacy and had the last available on-treatment HBV DNA ≥ 20 IU/mL
Week 48

次要结果测量

结果测量
措施说明
大体时间
Percentage of Participants With HBV DNA Levels ≥ 20 IU/mL at Week 96, as Determined by the Modified US FDA-Defined Snapshot Algorithm
大体时间:Week 96

The percentage of participants with HBV DNA ≥ 20 IU/mL at Week 96 was analyzed using the modified US FDA-defined snapshot algorithm, which included participants who:

  1. Had the last available on-treatment HBV DNA ≥ 20 IU/mL in the Week 96 analysis window (from Day 589 to Day 840, inclusive), or
  2. Did not have on-treatment HBV DNA data available in the Week 96 analysis window and

    • Discontinued study drug prior to or in the Week 96 analysis window due to lack of efficacy, or
    • Discontinued study drug prior to or in the Week 96 analysis window due to reason other than lack of efficacy and had the last available on-treatment HBV DNA ≥ 20 IU/mL
Week 96
Percentage of Participants With HBV DNA Levels < 20 IU/mL at Week 48
大体时间:Weeks 48
The percentage of participants with HBV DNA < 20 IU/mL at Week 48 was analyzed, which included participants who have the last available on-treatment HBV DNA, 20 IU/mL in the Week 48 analysis window. Missing=Failure (M = F) approach was used for analysis.
Weeks 48
Percentage of Participants With HBV DNA Levels < 20 IU/mL (Target Detected/Not Detected) at Week 48
大体时间:Week 48
The percentage of participants with HBV DNA < 20 IU/mL at Week 48 was analyzed, which included participants who have the last available on-treatment HBV DNA, 20 IU/mL in the Week 48 analysis window. The method of determining percentage of participants with HBV DNA levels <20 IU/mL (target detected/not detected i.e., lower limit of detection) at Week 48, was handled by M = F, and Missing=Excluded (M = E) approaches.
Week 48
Percentage of Participants With HBV DNA Levels < 20 IU/mL at Week 96
大体时间:Week 96
The percentage of participants with HBV DNA < 20 IU/mL at Week 96 was analyzed, which included participants who have the last available on-treatment HBV DNA, 20 IU/mL in the Week 96 analysis window. M = F approach was used for analysis.
Week 96
Percentage of Participants With HBV DNA Levels < 20 IU/mL (Target Detected/Not Detected) at Week 96
大体时间:Week 96
The percentage of participants with HBV DNA < 20 IU/mL at Week 96 was analyzed, which included participants who have the last available on-treatment HBV DNA, 20 IU/mL in the Week 96 analysis window. The method of determining percentage of participants with HBV DNA levels <20 IU/mL (target detected/not detected i.e., lower limit of detection) at Week 96, was handled by Missing=Failure (M = F), and Missing=Excluded (M = E) approaches.
Week 96
Percentage of Participants With Hepatitis B e Antigen (HBeAg) Loss at Week 48
大体时间:Week 48
HBeAg loss was defined as HBeAg changing from positive at baseline to negative at a postbaseline visit with baseline HBeAb negative or missing. The M = F approach was used for this analysis.
Week 48
Percentage of Participants With HBeAg Seroconversion at Week 48
大体时间:Week 48
HBeAg seroconversion was defined as HBeAg loss and HBeAb changing from negative/missing at baseline to positive at a postbaseline visit. The M = F approach was used for this analysis.
Week 48
Percentage of Participants With HBeAg Loss at Week 96
大体时间:Week 96
HBeAg loss was defined as HBeAg changing from positive at baseline to negative at a postbaseline visit with baseline HBeAb negative or missing. The M = F approach was used for this analysis.
Week 96
Percentage of Participants With HBeAg Seroconversion at Week 96
大体时间:Week 96
HBeAg seroconversion was defined as HBeAg loss and HBeAb changing from negative/missing at baseline to positive at a postbaseline visit. The M = F approach was used for this analysis.
Week 96
Percentage of Participants With Hepatitis B Surface Antigen (HBsAg) Loss at Week 48
大体时间:Week 48
HBsAg loss was defined as HBsAg changing from positive at baseline to negative at a postbaseline visit with baseline HBsAb negative or missing. The M = F approach was used for this analysis.
Week 48
Percentage of Participants With HBsAg Seroconversion at Week 48
大体时间:Week 48
HBsAg seroconversion was defined as HBsAg loss and HBsAb changes from negative/missing at baseline to positive at a postbaseline visit. The M = F approach was used for this analysis.
Week 48
Percentage of Participants With HBsAg Loss at Week 96
大体时间:Week 96
HBsAg loss was defined as HBsAg changing from positive at baseline to negative at a postbaseline visit with baseline HBsAb negative or missing. The M = F approach was used for this analysis.
Week 96
Percentage of Participants With HBsAg Seroconversion at Week 96
大体时间:Week 96
HBsAg seroconversion was defined as HBsAg loss and HBsAb changes from negative/missing at baseline to positive at a postbaseline visit. The M = F approach was used for this analysis.
Week 96
Percentage of Participants With Normal Alanine Aminotransferase (ALT) at Week 48 (by Central Laboratory and the American Association for the Study of Liver Diseases [AASLD] Criteria)
大体时间:Week 48
Central laboratory ULN for ALT were as follows: ≤ 43 U/L for males aged 18 to < 69 years and ≤ 35 U/L for males aged ≥ 69 years; ≤ 34 U/L for females aged 18 to < 69 years and ≤ 32 U/L for females aged ≥ 69 years. The ULN for ALT using the 2018 AASLD normal range was 25 U/L for females and 35 U/L for males. M = F approach was used for analysis.
Week 48
Percentage of Participants With Normalized ALT at Week 48 (by Central Laboratory and AASLD Criteria)
大体时间:Week 48
ALT normalization was defined as an ALT value that changed from above the normal range at baseline to within the normal range at the given postbaseline visit. Central laboratory ULN for ALT were as follows: ≤ 43 U/L for males aged 18 to < 69 years and ≤ 35 U/L for males aged ≥ 69 years; ≤ 34 U/L for females aged 18 to < 69 years and ≤ 32 U/L for females aged ≥ 69 years. The ULN for ALT using the 2018 AASLD normal range was 25 U/L for females and 35 U/L for males. M = F approach was used for analysis.
Week 48
Percentage of Participants With Normal ALT at Week 96 (by Central Laboratory and the AASLD Criteria)
大体时间:Week 96
Central laboratory ULN for ALT were as follows: ≤ 43 U/L for males aged 18 to < 69 years and ≤ 35 U/L for males aged ≥ 69 years; ≤ 34 U/L for females aged 18 to < 69 years and ≤ 32 U/L for females aged ≥ 69 years. The ULN for ALT using the 2018 AASLD normal range was 25 U/L for females and 35 U/L for males. M = F approach was used for analysis.
Week 96
Percentage of Participants With Normalized ALT at Week 96 (by Central Laboratory and AASLD Criteria)
大体时间:Week 96
ALT normalization was defined as an ALT value that changed from above the normal range at baseline to within the normal range at the given postbaseline visit. Central laboratory ULN for ALT were as follows: ≤ 43 U/L for males aged 18 to < 69 years and ≤ 35 U/L for males aged ≥ 69 years; ≤ 34 U/L for females aged 18 to < 69 years and ≤ 32 U/L for females aged ≥ 69 years. The ULN for ALT using the 2018 AASLD normal range was 25 U/L for females and 35 U/L for males. M = F approach was used for analysis.
Week 96
Change From Baseline in FibroTest® Score at Week 48
大体时间:Baseline; Week 48
The FibroTest score is used to assess liver fibrosis. Scores range from 0.00 to 1.00, with higher scores indicating a greater degree of fibrosis. Change from baseline was calculated as the value at Week 48 minus the value at Baseline.
Baseline; Week 48
Change From Baseline in FibroTest® Score at Week 96
大体时间:Baseline; Week 96
The FibroTest score is used to assess liver fibrosis. Scores range from 0.00 to 1.00, with higher scores indicating a greater degree of fibrosis. Change from baseline was calculated as the value at Week 96 minus the value at Baseline.
Baseline; Week 96
Percent Change From Baseline in Hip Bone Mineral Density (BMD) at Week 48
大体时间:Baseline; Week 48
Percent Change = Change from baseline at a postbaseline visit/baseline * 100%.
Baseline; Week 48
Percent Change From Baseline in Hip BMD at Week 96
大体时间:Baseline; Week 96
Percent Change = Change from baseline at a postbaseline visit/baseline * 100%.
Baseline; Week 96
Percent Change From Baseline in Spine BMD at Week 48
大体时间:Baseline; Week 48
Percent Change = Change from baseline at a postbaseline visit/baseline * 100%.
Baseline; Week 48
Percent Change From Baseline in Spine BMD at Week 96
大体时间:Baseline; Week 96
Percent Change = Change from baseline at a postbaseline visit/baseline * 100%.
Baseline; Week 96
Change From Baseline in Estimated Glomerular Filtration Rate Calculated Using the Cockcroft-Gault Equation (eGFR-CG) at Week 48
大体时间:Baseline; Week 48

Cockcroft-Gault formula is as follows:

  • For men: Glomerular filtration rate (GFR) = (140 - age in years) * body weight in kg / 72 * serum creatinine (mg/dL)
  • For women: GFR = 0.85 * (140 - age in years) * body weight in kg / 72 * serum creatinine (mg/dL).

Change from baseline was calculated as the value at Week 48 minus the value at Baseline.

Baseline; Week 48
Change From Baseline in eGFR-CG at Week 96
大体时间:Baseline; Week 96

Cockcroft-Gault formula is as follows:

  • For men: Glomerular filtration rate (GFR) = (140 - age in years) * body weight in kg / 72 * serum creatinine (mg/dL)
  • For women: GFR = 0.85 * (140 - age in years) * body weight in kg / 72 * serum creatinine (mg/dL).

Change from baseline was calculated as the value at Week 96 minus the value at Baseline.

Baseline; Week 96

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2016年12月29日

初级完成 (实际的)

2018年9月10日

研究完成 (实际的)

2020年1月30日

研究注册日期

首次提交

2016年11月29日

首先提交符合 QC 标准的

2016年11月29日

首次发布 (估计)

2016年12月1日

研究记录更新

最后更新发布 (实际的)

2020年9月14日

上次提交的符合 QC 标准的更新

2020年8月24日

最后验证

2020年8月1日

更多信息

与本研究相关的术语

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)?

是的

IPD 计划说明

Qualified external researchers may request IPD for this study after study completion. For more information, please visit our website at https://www.gilead.com/science-and-medicine/research/clinical-trials-transparency-and-data-sharing-policy

IPD 共享时间框架

18 months after study completion

IPD 共享访问标准

A secured external environment with username, password, and RSA code.

IPD 共享支持信息类型

  • 研究方案
  • 树液

药物和器械信息、研究文件

研究美国 FDA 监管的药品

是的

研究美国 FDA 监管的设备产品

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

慢性乙型肝炎的临床试验

  • Lapo Alinari
    招聘中
    伴有 MYC、BCL2 和 BCL6 重排的复发性高级别 B 细胞淋巴瘤 | 具有 MYC、BCL2 和 BCL6 重排的难治性高级 B 细胞淋巴瘤 | 伴有 MYC 和 BCL2 或 BCL6 重排的复发性高级别 B 细胞淋巴瘤 | 具有 MYC 和 BCL2 或 BCL6 重排的难治性高级 B 细胞淋巴瘤 | 复发性弥漫性大 B 细胞淋巴瘤活化 B 细胞型 | 难治性弥漫性大 B 细胞淋巴瘤活化 B 细胞型 | 将惰性 B 细胞非霍奇金淋巴瘤转化为弥漫性大 B 细胞淋巴瘤 | 复发性弥漫性大 B 细胞淋巴瘤生发中心 B 细胞型 | 难治性弥漫性大 B 细胞淋巴瘤生发中心 B 细胞型
    美国
  • Northwestern University
    National Cancer Institute (NCI)
    主动,不招人
    弥漫性大 B 细胞淋巴瘤 | 弥漫性大 B 细胞淋巴瘤,未另行说明 | 高级 B 细胞淋巴瘤,未另行说明 | 富含 T 细胞/组织细胞的大 B 细胞淋巴瘤 | 具有 MYC 和 BCL2 和/或 BCL6 重排的高级别 B 细胞淋巴瘤 | 弥漫性大 B 细胞淋巴瘤活化 B 细胞型 | 弥漫性大 B 细胞淋巴瘤生发中心 B 细胞型
    美国
  • Ohio State University Comprehensive Cancer Center
    招聘中
    弥漫性大 B 细胞淋巴瘤 | 高级别 B 细胞淋巴瘤 | 弥漫性大 B 细胞淋巴瘤,未另行说明 | 弥漫性大 B 细胞淋巴瘤生发中心 B 细胞型
    美国
  • Curocell Inc.
    招聘中
    高级别 B 细胞淋巴瘤 | 弥漫性大 B 细胞淋巴瘤 (DLBCL) | 原发性纵隔大 B 细胞淋巴瘤 (PMBCL) | 转化的滤泡性淋巴瘤 (TFL) | 难治性大 B 细胞淋巴瘤 | 复发性大 B 细胞淋巴瘤
    大韩民国
  • Roswell Park Cancer Institute
    National Cancer Institute (NCI); Amgen
    主动,不招人
    复发性弥漫性大 B 细胞淋巴瘤 | 难治性弥漫性大 B 细胞淋巴瘤 | CD20阳性 | I 期弥漫性大 B 细胞淋巴瘤 | II 期弥漫性大 B 细胞淋巴瘤 | III 期弥漫性大 B 细胞淋巴瘤 | IV 期弥漫性大 B 细胞淋巴瘤
    美国
  • National Cancer Institute (NCI)
    主动,不招人
    复发性弥漫性大 B 细胞淋巴瘤活化 B 细胞型 | 难治性弥漫性大 B 细胞淋巴瘤活化 B 细胞型
    美国, 沙特阿拉伯
  • National Cancer Institute (NCI)
    招聘中
    高级别 B 细胞淋巴瘤 | 弥漫性大 B 细胞淋巴瘤,未另行说明 | 将惰性 B 细胞非霍奇金淋巴瘤转化为弥漫性大 B 细胞淋巴瘤
    美国
  • Nathan Denlinger
    Bristol-Myers Squibb
    招聘中
    B 细胞非霍奇金淋巴瘤复发 | 弥漫性大 B 细胞淋巴瘤复发 | 滤泡性淋巴瘤-复发性 | 高级别 B 细胞淋巴瘤-复发 | 原发性纵隔大 B 细胞淋巴瘤复发 | 惰性 B 细胞非霍奇金淋巴瘤转化为弥漫性大 B 细胞淋巴瘤复发 | 难治性 B 细胞非霍奇金淋巴瘤 | 难治性弥漫性大 B 细胞淋巴瘤 | 滤泡性淋巴瘤难治性 | 高级别 B 细胞淋巴瘤难治性 | 原发性纵隔大 B 细胞淋巴瘤难治性 | 将惰性 B 细胞非霍奇金淋巴瘤转化为难治性弥漫性大 B 细胞淋巴瘤
    美国
  • Patrick C. Johnson, MD
    AstraZeneca
    招聘中
    难治性 B 细胞非霍奇金淋巴瘤 | 弥漫性大 B 细胞淋巴瘤 (DLBCL) | 3b 级滤泡性淋巴瘤 | 难治性侵袭性 B 细胞淋巴瘤 | 侵袭性 B 细胞 NHL | 从头或转化的惰性 B 细胞淋巴瘤 | DLBCL,Nos 遗传亚型 | 富含 T 细胞/组织细胞的大 B 细胞淋巴瘤 | EBV 阳性 DLBCL,编号 | 原发性纵隔 [胸腺] 大 B 细胞淋巴瘤 (PMBCL) | 高级 B 细胞淋巴瘤,编号 | C-MYC/BCL6 双重打击高级别 B 细胞淋巴瘤 | C-MYC/BCL2 双重打击高级别 B 细胞淋巴瘤
    美国
  • Northwestern University
    National Cancer Institute (NCI)
    招聘中
    复发性原发性纵隔(胸腺)大 B 细胞淋巴瘤 | 难治性原发性纵隔(胸腺)大 B 细胞淋巴瘤 | 伴有 MYC、BCL2 和 BCL6 重排的复发性高级别 B 细胞淋巴瘤 | 具有 MYC、BCL2 和 BCL6 重排的难治性高级 B 细胞淋巴瘤 | 复发性弥漫性大 B 细胞淋巴瘤,未另行说明 | 难治性弥漫性大 B 细胞淋巴瘤,未另行说明 | 复发性侵袭性 B 细胞非霍奇金淋巴瘤 | 难治性侵袭性 B 细胞非霍奇金淋巴瘤 | 复发性转化 B 细胞非霍奇金淋巴瘤 | 难治性转化 B 细胞非霍奇金淋巴瘤 | EBV 阳性弥漫性大 B 细胞淋巴瘤,未另行说明 | 高级 B 细胞淋巴瘤,未另行说明 | 与慢性炎症相关的弥漫性大 B 细胞淋巴瘤 | 伴 IRF4... 及其他条件
    美国

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3
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