title: HCV infection, B-cell non-Hodgkin's lymphoma and immunochemotherapy: Evidence and open questions.
abstract: There is plenty of data confirming that hepatitis C virus (HCV) infection is a predisposing factor for a B-cell non-Hodgkin's lymphoma (B-NHL) outbreak, while relatively few reports have addressed the role of HCV in affecting B-NHL patients' outcome. HCV infection may influence the short-term outcome of B-NHL because of the emergence of severe hepatic toxicity (HT) during immunochemotherapy. Furthermore, the long term outcome of HCV-related liver disease and patients' quality of life will possibly be affected by Rituximab maintenance, multiple-lines of toxicity during chemotherapy and hematopoietic stem cell transplantation. In this review, data dealing with aggressive and low-grade B-NHL were separately analyzed. The few retrospective papers reporting on aggressive B-NHL patients showed that HCV infection is a risk factor for the outbreak of severe HT during treatment. This adverse event not infrequently leads to the reduction of treatment density and intensity. Existing papers report that low-grade B-NHL patients with HCV infection may have a more widespread disease, more frequent relapses or a lower ORR compared to HCV-negative patients. Notwithstanding that, there is no statistical evidence that the prognosis of HCV-positive patients is inferior to that of HCV-negative subjects. HCV-positive prospective studies and longer follow-up are necessary to ascertain if HCV-positive B-NHL patients have inferior outcomes and if there are long term sequels of immunochemotherapies on the progression of liver disease.
authors.affiliation: Maria Christina Cox, Maria Antonietta Aloe-Spiriti, Elena Cavalieri, Eleonora Alma, Caterina Rebecchini, Department of Haematology, Sant'Andrea Hospital, La Sapienza University, 00139 Rome, Italy.
authors.forename: Maria Christina
authors.initials: MC
authors.lastname: Cox
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Aloe-Spiriti
authors.forename: Elena
authors.initials: E
authors.lastname: Cavalieri
authors.forename: Eleonora
authors.initials: E
authors.lastname: Alma
authors.forename: Elia
authors.initials: E
authors.lastname: Gigante
authors.forename: Paola
authors.initials: P
authors.lastname: Begini
authors.forename: Caterina
authors.initials: C
authors.lastname: Rebecchini
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Delle Fave
authors.forename: Massimo
authors.initials: M
authors.lastname: Marignani