title: Antiviral therapy is associated with a better survival in patients with hepatitis C virus and B-cell non-Hodgkin lymphomas, ANRS HC-13 lympho-C study.
abstract: Hepatitis C virus (HCV) infection increases the risk of B-cell non-Hodgkin lymphomas (B-NHL). Antiviral treatment (AT) can induce hematological responses in patients with marginal zone lymphomas (MZL). The ANRS HC-13 Lympho-C study aimed at a better understanding of the impact of AT on HCV associated B-NHL. This multicentric study enrolled 116 HCV-positive patients with B-NHL between 2006 and 2012. Cytological and histological samples were collected for centralized review. At lymphoma diagnosis, median age was 61 years and gender ratio M/F was 1. Cytohistological distribution was marginal zone lymphoma (MZL) n = 45 (39%), diffuse large B-cell lymphoma (DLBCL) n = 45 (39%), and other types n = 26 (22%). MZL patients had more frequent detection of rheumatoid factor (68% vs. 35%; P = 0.001) and more frequently mixed cryoglobulinemia (74% vs. 44%; P = 0.021) than patients with DLBCL. Among patients receiving AT, a sustained virologic response was achieved in 23 of 38 (61%) patients with MZL and in 9 of 17 (53%) with DLBCL (P = 0.42). Three-year overall survival (OS) and progression-free survival were 78% 95%CI [63-88] and 64% [48-76], respectively, without difference between cytohistological groups. Outcome analysis showed a favorable association between OS and AT in all patients (P = 0.05) and in the subgroup of MZL patients only (P = 0.04). Our data support that AT improves the outcomes of HCV-associated NHLs. The impact of new AT regimen with protease inhibitor needs to be investigated in this setting. [clinicalTrials.gov Identification number NCT01545544]
authors.affiliation: Department of Internal Medicine and Clinical Immunology, Paris Sud University, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Michot
authors.forename: Danielle
authors.initials: D
authors.lastname: Canioni
authors.forename: Henda
authors.initials: H
authors.lastname: Driss
authors.forename: Laurent
authors.initials: L
authors.lastname: Alric
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
authors.forename: Felipe
authors.initials: F
authors.lastname: Suarez
authors.forename: David
authors.initials: D
authors.lastname: Sibon
authors.forename: Catherine
authors.initials: C
authors.lastname: Thieblemont
authors.forename: Jehan
authors.initials: J
authors.lastname: Dupuis
authors.forename: Benjamin
authors.initials: B
authors.lastname: Terrier
authors.forename: Cyrille
authors.initials: C
authors.lastname: Feray
authors.forename: Hervé
authors.initials: H
authors.lastname: Tilly
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
authors.forename: Véronique
authors.initials: V
authors.lastname: Leblond
authors.forename: Catherine
authors.initials: C
authors.lastname: Settegrana
authors.forename: Pascaline
authors.initials: P
authors.lastname: Rabiega
authors.forename: Yoann
authors.initials: Y
authors.lastname: Barthe
authors.forename: Houria
authors.initials: H
authors.lastname: Hendel-Chavez
authors.forename: Florence
authors.initials: F
authors.lastname: Nguyen-Khac
authors.forename: Hélène
authors.initials: H
authors.lastname: Merle-Béral
authors.forename: Françoise
authors.initials: F
authors.lastname: Berger
authors.forename: Thierry
authors.initials: T
authors.lastname: Molina
authors.forename: Frédéric
authors.initials: F
authors.lastname: Charlotte
authors.forename: Fabrice
authors.initials: F
authors.lastname: Carrat
authors.forename: Frédéric
authors.initials: F
authors.lastname: Davi
authors.forename: Olivier
authors.initials: O
authors.lastname: Hermine
authors.forename: Caroline
authors.initials: C
authors.lastname: Besson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols; D000998:Antiviral Agents / Q000627:therapeutic use*; D003449:Cryoglobulinemia / Q000503:physiopathology; D005260:Female; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012217:Rheumatoid Factor / Q000097:blood; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D012217:Rheumatoid Factor