title: Distinctive natural history in hepatitis C virus positive diffuse large B-cell lymphoma: analysis of 156 patients from northern Italy.
abstract: BACKGROUND
  Diffuse large B-cell lymphoma (DLBCL) has been correlated to hepatitis C virus (HCV) infection in few series, but characteristics and outcome of these patients remain undefined.
  
  
  METHODS
  We analyzed 156 previously untreated consecutive HCV-positive patients with DLBCL observed between 1994 and 2004 in three major institutions from northern Italy.
  
  
  RESULTS
  Median age at presentation was 63 years and 8% of patients had DLBCL transformed from low-grade lymphomas. Spleen was the most frequently involved extranodal site, followed by liver and stomach. Treatment was delivered with cure-intent in 132 patients, while the remaining 24 patients received monochemotherapy or radiotherapy alone due to old age or seriously impaired hepatic function. Only five patients (4%) had to discontinue chemotherapy due to severe liver function impairment. The addition of rituximab did not seem to affect patients' tolerance to treatment. Five-year overall survival of the entire cohort was 72%, while 5-year progression-free survival (PFS) of the 132 patients treated with cure-intent was 51%. Hepatitis B virus co-infection, advanced Ann Arbor stage and nodal origin of the tumor resulted the strongest adverse prognostic factors.
  
  
  CONCLUSIONS
  Patients with HCV-positive DLBCL share distinctive clinical features. Future studies should prospectively evaluate the association between HCV and aggressive lymphomas.
authors.affiliation: Department of Hematology, Ospedale S. Bortolo, Vicenza, Italy. carlovisco@hotmail.com
authors.forename: C
authors.initials: C
authors.lastname: Visco
authors.forename: L
authors.initials: L
authors.lastname: Arcaini
authors.forename: E
authors.initials: E
authors.lastname: Brusamolino
authors.forename: S
authors.initials: S
authors.lastname: Burcheri
authors.forename: A
authors.initials: A
authors.lastname: Ambrosetti
authors.forename: M
authors.initials: M
authors.lastname: Merli
authors.forename: E
authors.initials: E
authors.lastname: Bonoldi
authors.forename: M
authors.initials: M
authors.lastname: Chilosi
authors.forename: A
authors.initials: A
authors.lastname: Viglio
authors.forename: M
authors.initials: M
authors.lastname: Lazzarino
authors.forename: G
authors.initials: G
authors.lastname: Pizzolo
authors.forename: F
authors.initials: F
authors.lastname: Rodeghiero
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D016174:Hepacivirus / Q000472:pathogenicity*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D007150:Immunohistochemistry; D007558:Italy / Q000453:epidemiology; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000209:etiology / Q000473:pathology / Q000821:virology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis