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Clinico-biological characteristics and outcome of hepatitis C virus-positive patients with diffuse large B-cell lymphoma treated with immunochemotherapy

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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.

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Acknowledgements

This work was supported in part by the Instituto de Salud Carlos III, Spanish Ministry of Health (PI12/01536 and PIE1313/00033); Red Temática de Investigación Cooperativa en Cáncer (RTICC, RD12/0036/0023), all co-founded by the European Regional Development Fund (FEDER); by Agència de Gestió d’Ajuts Universitaris i de Recerca (AGAUR, 2014 SGR 668), Generalitat de Catalunya, and by the “Josep Font” grant from Hospital Clinic Barcelona.

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Authors and Affiliations

  1. Department of Hematology, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain

    Ivan Dlouhy, Miguel Á. Torrente, Jordina Rovira, Laura Magnano, Eva Giné, Julio Delgado & Armando López-Guillermo

  2. Department of Hepatology, Hospital Clínic, Barcelona, Spain

    Sabela Lens, Xavier Forns & José M. Sánchez-Tapias

  3. Department of Pathology, Hospital Clínic, Barcelona, Spain

    Olga Balagué, Antonio Martínez & Elías Campo

  4. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain

    Elías Campo & Armando López-Guillermo

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  1. Ivan Dlouhy
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  2. Miguel Á. Torrente
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  3. Sabela Lens
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  9. Antonio Martínez
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  11. Xavier Forns
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Correspondence to Ivan Dlouhy.

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The authors declare that they have no conflict of interest.

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Ivan Dlouhy and Miguel Á. Torrente equally contributed to this manuscript

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Supplementary Fig 1

Progression-free survival (PFS) and overall survival (OS) of the overall cohort with diffuse large B-cell lymphoma (TIFF 96 kb)

High resolution image (GIF 15 kb)

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Dlouhy, I., Torrente, M.Á., Lens, S. et al. Clinico-biological characteristics and outcome of hepatitis C virus-positive patients with diffuse large B-cell lymphoma treated with immunochemotherapy. Ann Hematol 96, 405–410 (2017). https://doi.org/10.1007/s00277-016-2903-8

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  • DOI: https://doi.org/10.1007/s00277-016-2903-8

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