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29.12.2016 | Original Article | Ausgabe 3/2017

Annals of Hematology 3/2017

Clinico-biological characteristics and outcome of hepatitis C virus-positive patients with diffuse large B-cell lymphoma treated with immunochemotherapy

Zeitschrift:
Annals of Hematology > Ausgabe 3/2017
Autoren:
Ivan Dlouhy, Miguel Á. Torrente, Sabela Lens, Jordina Rovira, Laura Magnano, Eva Giné, Julio Delgado, Olga Balagué, Antonio Martínez, Elías Campo, Xavier Forns, José M. Sánchez-Tapias, Armando López-Guillermo
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00277-016-2903-8) contains supplementary material, which is available to authorized users.
Ivan Dlouhy and Miguel Á. Torrente equally contributed to this manuscript

Abstract

Diffuse large B cell lymphoma (DLBCL) patients carrying hepatitis C virus (HCV) have higher risk of treatment toxicity and complications. The aim of this study was to assess the impact of HCV in a series of DLBCL patients treated with immunochemotherapy. 321 patients (161 M/160F; median age, 66 years) diagnosed with de novo DLBCL in a single center between 2002 and 2013 were included. Immunodeficiency-related lymphomas were excluded. HCV+ cases were defined by the presence of IgG anti-HCV. Main clinico-biological characteristics and outcome were analyzed according to the viral status. Two hundred ninety patients were HCV− and 31 HCV+. HCV+ patients were older (median age 71 vs. 64 years, P = 0.03), had more often B symptoms (P = 0.013), spleen (P = 0.003), and liver (P = 0.011) involvement, higher rate of early death (<4 months, P = .001), and shorter overall survival (OS). Eleven HCV+ patients had cirrhosis criteria. HCV+ patients with impaired liver function before or during treatment showed inferior OS. Elevated pre-treatment bilirubin correlated also with higher liver toxicity. In a multivariate analysis that included R-IPI score, serum beta2-microglobulin (β2m), HCV status, and presence of cirrhosis, only R-IPI, β2m, and cirrhosis showed independent prognostic impact on OS. The presence of HCV in DLBCL patients entails higher number of complications and early deaths; however, liver impairment and not the hepatitis viral status was the key feature in the outcome of the patients.

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