ABCL-300: The Relation Between Hepatitis C Infection and Cell of Origin (COO) of Diffuse Large B-Cell Lymphoma (DLBCL) and the Prognostic Value of Both Factors (Egyptian Experience)

Abstract

Context COO has a significant prognostic impact on DLBCL outcome. HCV plays a great role in B-cell proliferation and transformation to NHL. Objective This study was conducted to emphasize the impact of COO classification on survival in DLBCL and its correlation to HCV infection. Design This prospective study was conducted on 50 cases of DLBCL. Setting This study was conducted on patients with DLBCL in OCMU in Egypt. Patients The mean age of our patients was 55 years, and 58% of them were female. Interventions DLBCL histopathological diagnosis was performed by evaluating hematoxylin and eosin-stained sections from formalin-fixed, paraffin-embedded tissue blocks from the tumor, combined with CD20 stain. COO was detected by using the Hans algorithm. RT-PCR for HCV infection was done for all patients. All patients received induction with the CHOP protocol. Main Outcomes Whether HCV-positive patients would have shorter survival. Results About 51.5% of non-GCB cases were stage IV in correlation to only 35.5% of GCB cases, with significant p-value (p-value = 0.002). Also, about 21% of non-GCB cases showed relapse in comparison to only 11.8% of GCB cases, with no significance. Therefore, non-GCB predicts a dismal outcome in NHL. In regard to the correlation between survival and COO, GCB cases showed significantly prolonged PFS and OS (78 and 88 months, respectively) in comparison to only 40.5 and 31 months for non-GCB cases (p-values = 0.054 and 0.024). There was a significant correlation between HCV positivity and attaining CR (p-value = 0.025). Also, HCV-positive patients showed shortened PFS and OS in comparison to HCV-negative cases, although not significant. In regard to the correlation between HCV status and COO, about 25% of GCB cases were HCV positive in comparison to 58.8% of non-GCB, with a p-value of 0.026. In multivariate analysis, GCB, low- and low-intermediate IPI, and CR achievement were considered independent predictors of survival (p-values = 0.004, 0.015, and 0.001, respectively). Conclusions The Hans algorithm is a good predictor of survival in B-NHL. HCV positivity has a poor impact on outcomes in NHL. There is possibly a correlation between HCV infection and COO for lymphoma, which needs further analysis.