title: Antiviral treatment in patients with indolent B-cell lymphomas associated with HCV infection: a study of the Fondazione Italiana Linfomi.
abstract: BACKGROUND
  Tumor regression after antiviral therapy (AT) is in favor of an etiological role of hepatitis C virus (HCV) in non-Hodgkin's B-cell lymphomas (NHL).
  
  
  METHODS
  We carried out a cohort study of 704 consecutive HIV-negative, HCV-positive patients with indolent NHL diagnosed and treated from 1993 to 2009 in 39 centers of the Fondazione Italiana Linfomi; 134 patients were managed with AT for lymphoma control.
  
  
  RESULTS
  For entire cohort, 5-year overall survival (OS) was 78% [95% confidence interval (CI): 74%-82%] and 5-year progression-free survival (PFS) was 48% (95% CI: 44%-53%). In multivariate analysis, the use of AT during the patients' life had positive impact on OS. Forty-four of the 100 patients treated with first-line AT achieved a complete remission (CR) and 33 a partial response (PR). HCV-RNA clearance was achieved in 80 patients and was related to lymphoma response. At a median follow-up of 3.6 years, 5-year PFS was 63% (95% CI: 50%-73%). CR + PR rate was 85% with AT as second-line treatment.
  
  
  CONCLUSIONS
  AT produces HCV-RNA clearance and consequent tumor regression in most patients with HCV-related indolent NHL. AT used at any time is associated with improved OS. Consequently, AT can be considered an option for patients with indolent lymphomas who do not need immediate cytoreductive treatment.
authors.affiliation: Department of Molecular Medicine, University of Pavia, Pavia; Department of Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia. Electronic address: luca.arcaini@unipv.it.
authors.forename: L
authors.initials: L
authors.lastname: Arcaini
authors.affiliation: Division of Hematology, Ospedale Giovanni da Saliceto, Piacenza.
authors.forename: D
authors.initials: D
authors.lastname: Vallisa
authors.affiliation: Department of Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia.
authors.forename: S
authors.initials: S
authors.lastname: Rattotti
authors.affiliation: Department of Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia.
authors.forename: V V
authors.initials: VV
authors.lastname: Ferretti
authors.affiliation: Unit of Lymphoid Malignancies, San Raffaele Scientific Institute, Milano.
authors.forename: A J M
authors.initials: AJM
authors.lastname: Ferreri
authors.affiliation: Division of Hematology, Ospedale Giovanni da Saliceto, Piacenza.
authors.forename: P
authors.initials: P
authors.lastname: Bernuzzi
authors.affiliation: Division of Hematology, Department of Internal Medicine, Ospedale di Circolo, Fondazione Macchi, Varese.
authors.forename: M
authors.initials: M
authors.lastname: Merli
authors.affiliation: Department of Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia.
authors.forename: M
authors.initials: M
authors.lastname: Varettoni
authors.affiliation: Division of Hematology 2, AO S Giovanni Battista, Torino.
authors.forename: A
authors.initials: A
authors.lastname: Chiappella
authors.affiliation: Department of Medicine, Section of Hematology, University of Verona, Verona.
authors.forename: A
authors.initials: A
authors.lastname: Ambrosetti
authors.affiliation: Division of Hematology, Spedali Civili, Brescia.
authors.forename: A
authors.initials: A
authors.lastname: Tucci
authors.affiliation: Division of Hematology, Ospedale Niguarda Ca' Granda, Milano.
authors.forename: C
authors.initials: C
authors.lastname: Rusconi
authors.affiliation: Division of Hematology, Ospedale San Bortolo, Vicenza.
authors.forename: C
authors.initials: C
authors.lastname: Visco
authors.affiliation: Division of Medical Oncology, National Cancer Center, Aviano.
authors.forename: M
authors.initials: M
authors.lastname: Spina
authors.affiliation: Division of Hematology, Osp A Businco, Cagliari.
authors.forename: G
authors.initials: G
authors.lastname: Cabras
authors.affiliation: Department of Oncology and Hematology, University of Modena and Reggio Emilia, Modena.
authors.forename: S
authors.initials: S
authors.lastname: Luminari
authors.affiliation: IMO, Department of Internal Medicine and Clinical Oncology, University of Bari, Aldo Moro, Bari.
authors.forename: M
authors.initials: M
authors.lastname: Tucci
authors.affiliation: Scientific Direction, IRCCS, Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture.
authors.forename: P
authors.initials: P
authors.lastname: Musto
authors.affiliation: Division of Hematology, Department of Experimental Medicine and Oncology, University of Torino, Torino.
authors.forename: M
authors.initials: M
authors.lastname: Ladetto
authors.affiliation: Hematology Unit, Department of Oncology, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia.
authors.forename: F
authors.initials: F
authors.lastname: Merli
authors.affiliation: Division of Hematology, Dipartimento di Ematologia, Ospedale M. Morelli, Reggio Calabria.
authors.forename: C
authors.initials: C
authors.lastname: Stelitano
authors.affiliation: Division of Oncohematology, Ospedale Umberto I, Nocera Inferiore.
authors.forename: A
authors.initials: A
authors.lastname: d'Arco
authors.affiliation: Division of Hematology, Azienda Ospedaliero Universitaria Careggi, Firenze.
authors.forename: L
authors.initials: L
authors.lastname: Rigacci
authors.affiliation: Division of Hematology, Azienda Ospedaliera SS Arrigo e Biagio e Cesare Arrigo, Alessandria.
authors.forename: A
authors.initials: A
authors.lastname: Levis
authors.affiliation: Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara.
authors.forename: D
authors.initials: D
authors.lastname: Rossi
authors.affiliation: Division of Haematology, Hospital of Cremona, Cremona.
authors.forename: P
authors.initials: P
authors.lastname: Spedini
authors.affiliation: Division of Hematology, Policlinico, Palermo.
authors.forename: S
authors.initials: S
authors.lastname: Mancuso
authors.affiliation: Department of Oncology, Istituto Oncologico Veneto, IRCCS, Padova.
authors.forename: D
authors.initials: D
authors.lastname: Marino
authors.affiliation: Division of Infectious and Tropical Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia; Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia.
authors.forename: R
authors.initials: R
authors.lastname: Bruno
authors.affiliation: Division of Hematology, Fondazione IRCCS Cà Granda OM Policlinico, Università degli Studi, Milano.
authors.forename: L
authors.initials: L
authors.lastname: Baldini
authors.affiliation: Division of Hematology, Sapienza University, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Pulsoni
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
chemical_list: D000998:Antiviral Agents
keywords: HCV; antiviral treatment; indolent lymphoma; outcome