title: Impact of treatment-related toxicity on outcome of HCV-positive diffuse large B-cell lymphoma in rituximab era.
abstract: NOVELTY AND IMPACT: This first study compares the survival of HCV-positive DLBCL treated with and without rituximab which showed in toxicity and the outcome.
  
  
  BACKGROUND
  The effect of hepatitis C virus (HCV) infection on prognosis and hepatic toxicity in patients with diffuse large B-cell lymphoma (DLBCL) in the rituximab era is unclear. The treatment and the outcome of patients with DLBCL and HCV infection are still a matter of debate.
  
  
  METHODS
  We analyzed 137 DLBCL patients positive to HCV, treated with chemotherapy regimens include cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) ± rituximab. Survival outcomes and hepatic toxicity were compared in DLBCL patients positive to HCV infection according to CHOP ± rituximab.
  
  
  RESULTS
  Our result showed that the group of patients treated with R-CHOP has significant high incidence of hepatic toxicity grade (3-4) (28 vs. 18%, P value 0.001) and worse progression-free survival (55 vs. 80%, P value 0.002) in comparison with the group treated with CHOP, and also there is significant difference between both groups in overall survival. This first study compares the survival of HCV-positive DLBCL treated with and without rituximab which showed significant differences.
  
  
  CONCLUSIONS
  We conclude that HCV-positive patients with DLBCL treated with rituximab plus CHOP have high incidence in hepatic toxicity. Speciﬁc protocols evaluating antiviral therapy should be designed for these patients.
authors.forename: Amen Hamdy
authors.initials: AH
authors.lastname: Zaky
authors.forename: Rania
authors.initials: R
authors.lastname: Bakry
authors.forename: Mohamed I
authors.initials: MI
authors.lastname: El-sayed
authors.forename: Mostafa Abd
authors.initials: MA
authors.lastname: Elwanis
authors.forename: Ola
authors.initials: O
authors.lastname: Nabih
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology* / Q000401:mortality; D003520:Cyclophosphamide / Q000008:administration & dosage; D018450:Disease Progression; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D016174:Hepacivirus / Q000502:physiology; D006526:Hepatitis C / Q000188:drug therapy* / Q000821:virology; D054884:Host-Pathogen Interactions / Q000187:drug effects; D006801:Humans; D053208:Kaplan-Meier Estimate; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000401:mortality / Q000821:virology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D000069283:Rituximab; D015996:Survival Rate; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: Diffuse large B-cell lymphoma; HCV; Rituximab