Abstract
Background: Hepatitis C virus (HCV) in diffuse large B-cell lymphoma (DLBCL) is associated with a higher prevalence and distinctive clinical characteristics and outcomes. Methods: A retrospective analysis of adult DLBCL patients from 2011 to 2015 was studied. Results: A total of 206 adult DLBCL were enrolled with 22 (10.7%) HCV-positive patients. Compared to HCV-negative patients, the HCV-positive group had a poor performance status (p = 0.011), lower platelet count (p = 0.029), and higher spleen and liver involvement incidences (liver involvement, p = 0.027, spleen involvement, p = 0.026), and they received fewer cycles of chemotherapy significantly due to morbidity and mortality (p = 0.048). Overall survival was shorter in HCV-positive DLBCL (25.3 months in HCV-positive vs. not reached (NR), p = 0.049). With multivariate analysis, poor performance status (p < 0.001), advanced stage (p < 0.001), less chemotherapy cycles (p < 0.001), and the presence of liver toxicity (p = 0.001) contributed to poor OS in DLBCL. Among HCV-positive DLBCL, the severity of liver fibrosis was the main risk factor related to death. Conclusion: Inferior survival of HCV-positive DLBCL was observed and associated with poor performance status, higher numbers of complications, and intolerance of treatment, leading to fewer therapy. Therefore, anti-HCV therapy, such as direct-acting antiviral agents, might benefit these patients in the future.
Highlights
Hepatitis C virus (HCV) infection is one of the major causes of chronic liver disease around the world with a prevalence rate of around 3% [1]
The characteristics at the time of diagnosis are listed in HCV-negative patients had better performance status compared to HCV-positive patients (p = 0.011)
There were no significant differences on sex, B symptoms, bone marrow involvement, international prognostic index (IPI) score, revised international prognostic index (R-IPI) score, HBsAg status, white blood cell (WBC) count, hemoglobin, albumin, lactate dehydrogenase (LDH) levels, alanine aminotransferase (GPT)
Summary
Hepatitis C virus (HCV) infection is one of the major causes of chronic liver disease around the world with a prevalence rate of around 3% [1]. HCV-positive DLBCLs display specific clinical features and outcomes, the optimal treatment and timing of anti-HCV therapy in aggressive lymphoma is still uncertain [1,13,14,15,16]. Previous reports showed that HCV-positive patients with DLBCL exhibited worse overall survival (OS), and the incidence of severe hepatic toxicity in HCV-positive patients was significantly higher than that of HCV-negative patients [13,17]. All these studies only included small numbers of HCV-positive patients, and not all studies regarding HCV infection and DLBCL showed consistent results
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