title: Clinico-biological characteristics and outcome of hepatitis C virus-positive patients with diffuse large B-cell lymphoma treated with immunochemotherapy.
abstract: Diffuse large B cell lymphoma (DLBCL) patients carrying hepatitis C virus (HCV) have higher risk of treatment toxicity and complications. The aim of this study was to assess the impact of HCV in a series of DLBCL patients treated with immunochemotherapy. 321 patients (161 M/160F; median age, 66 years) diagnosed with de novo DLBCL in a single center between 2002 and 2013 were included. Immunodeficiency-related lymphomas were excluded. HCV+ cases were defined by the presence of IgG anti-HCV. Main clinico-biological characteristics and outcome were analyzed according to the viral status. Two hundred ninety patients were HCV- and 31 HCV+. HCV+ patients were older (median age 71 vs. 64 years, P = 0.03), had more often B symptoms (P = 0.013), spleen (P = 0.003), and liver (P = 0.011) involvement, higher rate of early death (<4 months, P = .001), and shorter overall survival (OS). Eleven HCV+ patients had cirrhosis criteria. HCV+ patients with impaired liver function before or during treatment showed inferior OS. Elevated pre-treatment bilirubin correlated also with higher liver toxicity. In a multivariate analysis that included R-IPI score, serum beta2-microglobulin (β2m), HCV status, and presence of cirrhosis, only R-IPI, β2m, and cirrhosis showed independent prognostic impact on OS. The presence of HCV in DLBCL patients entails higher number of complications and early deaths; however, liver impairment and not the hepatitis viral status was the key feature in the outcome of the patients.
authors.affiliation: Department of Hematology, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain. idlouhy@clinic.ub.es.
authors.forename: Ivan
authors.initials: I
authors.lastname: Dlouhy
authors.affiliation: Department of Hematology, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain.
authors.forename: Miguel Á
authors.initials: MÁ
authors.lastname: Torrente
authors.affiliation: Department of Hepatology, Hospital Clínic, Barcelona, Spain.
authors.forename: Sabela
authors.initials: S
authors.lastname: Lens
authors.affiliation: Department of Hematology, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain.
authors.forename: Jordina
authors.initials: J
authors.lastname: Rovira
authors.affiliation: Department of Hematology, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Magnano
authors.affiliation: Department of Hematology, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Giné
authors.affiliation: Department of Hematology, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Delgado
authors.affiliation: Department of Pathology, Hospital Clínic, Barcelona, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Balagué
authors.affiliation: Department of Pathology, Hospital Clínic, Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Martínez
authors.affiliation: Department of Pathology, Hospital Clínic, Barcelona, Spain.|Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
authors.forename: Elías
authors.initials: E
authors.lastname: Campo
authors.affiliation: Department of Hepatology, Hospital Clínic, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Forns
authors.affiliation: Department of Hepatology, Hospital Clínic, Barcelona, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Sánchez-Tapias
authors.affiliation: Department of Hematology, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain.|Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
authors.forename: Armando
authors.initials: A
authors.lastname: López-Guillermo
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus; D006526:Hepatitis C / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D007167:Immunotherapy / Q000379:methods* / Q000401:mortality; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
keywords: Diffuse large B cell lymphoma; Hepatic toxicity; Hepatitis C virus; Immunochemotherapy; Outcome