Antiviral therapy after complete response to chemotherapy could be efficacious in HCV-positive non-Hodgkin's lymphoma.
OBJECTIVE
Prevalence of HCV infection in non-Hodgkin's lymphoma is high. The impact of antiviral therapy on the natural history of this subgroup of lymphomas after a successful chemotherapy regimen is still an argument of debate.


METHODS
We retrospectively examined 343 chemotherapy-treated patients referred to our centre for five consecutive years. Clinical and histological characteristics, disease free-survival (DFS) and overall-survival (OS) were compared in HCV-positive (69/343) and HCV-negative (274/343) patients. Twenty-five HCV-positive patients received antiviral treatment following chemotherapy discontinuation. Uni- and multivariate analyses were performed.


RESULTS
20% of lymphomas were HCV-positive. Indolent histology was prevalent in the HCV-positive group (p<0.05); no significant differences in OS or DFS were found between the two groups; in HCV-positive subjects, antiviral therapy, was associated with a longer DFS (p<0.05); none of the HCV-positive subjects who achieved a virological response experienced any lymphoma relapse; 29% of non responders did; at multivariate analysis, the independent factors related to a better clinical outcome were: indolent histology at the onset of lymphoma and antiviral therapy.


CONCLUSIONS
Antiviral treatment in HCV-positive non-Hodgkin's lymphoma may be an important strategy to reinforce the results of a successful chemotherapy regimen; further studies are needed to validate this combined approach.
La Mura
Vincenzo
V
Internal Medicine and Hepatology Unit, Second University of Naples, Napoli, Italy.
De Renzo
Amalia
A
Perna
Fabiana
F
D'Agostino
Diego
D
Masarone
Mario
M
Romano
Marco
M
Bruno
Savino
S
Torella
Roberto
R
Persico
Marcello
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D016174:Hepacivirus / Q000472:pathogenicity; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000473:pathology / Q000821:virology; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
D000970:Antineoplastic Agents; D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons