Biological features and outcome of diffuse large B-cell lymphoma associated with hepatitis C virus in elderly patients: Results of the prospective 'Elderly Project' by the Fondazione Italiana Linfomi.
Aged
Humans
Hepacivirus
/ genetics
Antiviral Agents
/ therapeutic use
Prospective Studies
Hepatitis C, Chronic
/ drug therapy
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Neoplasm Recurrence, Local
/ drug therapy
Hepatitis C
/ drug therapy
Rituximab
/ therapeutic use
Doxorubicin
/ therapeutic use
Lymphoma, Large B-Cell, Diffuse
Vincristine
/ therapeutic use
Cyclophosphamide
/ therapeutic use
Prednisone
/ therapeutic use
diffuse large B-cell lymphoma
elderly
hepatitis C virus
Journal
British journal of haematology
ISSN: 1365-2141
Titre abrégé: Br J Haematol
Pays: England
ID NLM: 0372544
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
revised:
23
12
2022
received:
21
10
2022
accepted:
18
01
2023
medline:
4
5
2023
pubmed:
4
2
2023
entrez:
3
2
2023
Statut:
ppublish
Résumé
Up to 10%-15% of diffuse large B-cell lymphoma (DLBCL) are related to hepatitis C virus (HCV) infection, in particular in elderly patients. The Fondazione Italiana Linfomi has recently published a multicentre prospective observational study, the 'Elderly Project', on the outcome of DLBCL in patients aged ≥65 years, evaluated using a simplified comprehensive geriatric assessment. The aim of this study was to compare biological and clinical features of HCV positive (HCV+) with HCV negative (HCV-) cases. A total of 89 HCV+ patients were identified out of 1095 evaluated for HCV serology (8.1%). The HCV+ patients were older, less fit, and had frequent extranodal involvement. The cell-of-origin determination by Nanostring showed that HCV+ cases less frequently had an activated B-cell profile compared to HCV- patients (18% vs. 43%). In all, 86% of HCV+ patients received rituximab-cyclophosphamide, doxorubicin, vincristine (Oncovin) and prednisone (R-CHOP)-like immunochemotherapy. Grade 3-4 liver toxicity occurred in 3% of cases. Among centrally reviewed cases confirmed as DLBCL, the 3-year overall survival of HCV+ patients was very similar to HCV- (63% vs. 61%, p = 0.926). In all, 20 HCV+ patients were treated with direct-acting antiviral agents (DAAs), with good tolerance and sustained virological response in all cases. The 3-year progression-free survival for this subgroup was excellent (77%), suggesting DAAs' possible role in reducing the risk of relapse by eliminating the viral trigger.
Substances chimiques
Antiviral Agents
0
Rituximab
4F4X42SYQ6
Doxorubicin
80168379AG
Vincristine
5J49Q6B70F
Cyclophosphamide
8N3DW7272P
Prednisone
VB0R961HZT
Types de publication
Observational Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
653-662Informations de copyright
© 2023 British Society for Haematology and John Wiley & Sons Ltd.
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