Abstract
The purpose of this study is to study the usefulness of post-remission antiviral therapy in cases of HCV-RNA-positive diffuse large-cell lymphoma. Antiviral therapy against HCV was performed after remission using CHOP or CHOP-like chemotherapy in combination with rituximab in five successive cases of HCV-RNA-positive diffuse large-cell lymphoma. The control groups consisted of a group of HCV-RNA-positive diffuse large-cell lymphoma cases prior to this trial (control 1), and a group of cases that tested negative for HIV, HCV, and HBV (control 2). All the cases were in remission at the time of initial treatment. There were no significant differences between the three groups in terms of age, sex, treatment, stage, or International Prognosis Index (IPI). When HCV antiviral therapy was performed after treatment for diffuse large-cell lymphoma, we observed no recurrence or deaths, and the 2-year overall survival and progression-free survival rates were significantly greater than those in the control 1 group (P = 0.0246). It is possible that a better prognosis can be achieved by performing HCV antiviral therapy after achieving remission in cases of HCV-RNA-positive diffuse large-cell lymphoma through the use of R-CHOP or similar treatments.
Highlights
The hepatitis C virus (HCV) is considered to be one of the causative factors of liver cancer, and in HCV cases that have reached the stage of cirrhosis, the incidence of liver cancer is reckoned to be 23 to 35 times higher compared with that of healthy people [1, 2]
The age of patients receiving direct-acting antiviral agent (DAA) therapy ranged from 63 to 75 years, while the control 1 group ranged from 55 to 80 years, and the control 2 group ranged from 39 to 85 years, there was no difference between the groups in terms of cancer staging, and there was no significant difference in the International Prognosis Index between the groups, even after dividing them into risk groups or low/low-int and int-high subgroups
Since HCV is often stained in tissue samples, and since cases where there is a drop in HCV viral RNA are less likely to recur [7], it is suggested that HCV is directly or indirectly associated with the occurrence and progression of lymphoma
Summary
The hepatitis C virus (HCV) is considered to be one of the causative factors of liver cancer, and in HCV cases that have reached the stage of cirrhosis, the incidence of liver cancer is reckoned to be 23 to 35 times higher compared with that of healthy people [1, 2]. It is possible that HCV contributes to lymphoproliferative disease, there are still many uncertainties, including whether or not there is direct genetic involvement or if it contributes indirectly to the virus through chronic inflammation or the like, whether the high rate of recurrence is caused by the immune monitoring mechanism breaking down due to HCV infection, or whether therapeutic benefits are difficult to achieve [5]. When lymphoma specimens from HCV-positive lymphoma cases were stained with HCV-specific antibodies, 76.9% of the HCV-specific antibodies (including strong positive and weak positive) were positive in the lymphoma specimens. In this analysis, there was no difference in the strength of HCV-specific
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