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World J Gastrointest Oncol. 2012 Mar 15;4(3):46-53. doi: 10.4251/wjgo.v4.i3.46.

HCV infection, B-cell non-Hodgkin's lymphoma and immunochemotherapy: Evidence and open questions.

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  • 1Maria Christina Cox, Maria Antonietta Aloe-Spiriti, Elena Cavalieri, Eleonora Alma, Caterina Rebecchini, Department of Haematology, Sant'Andrea Hospital, La Sapienza University, 00139 Rome, Italy.

Abstract

There is plenty of data confirming that hepatitis C virus (HCV) infection is a predisposing factor for a B-cell non-Hodgkin's lymphoma (B-NHL) outbreak, while relatively few reports have addressed the role of HCV in affecting B-NHL patients' outcome. HCV infection may influence the short-term outcome of B-NHL because of the emergence of severe hepatic toxicity (HT) during immunochemotherapy. Furthermore, the long term outcome of HCV-related liver disease and patients' quality of life will possibly be affected by Rituximab maintenance, multiple-lines of toxicity during chemotherapy and hematopoietic stem cell transplantation. In this review, data dealing with aggressive and low-grade B-NHL were separately analyzed. The few retrospective papers reporting on aggressive B-NHL patients showed that HCV infection is a risk factor for the outbreak of severe HT during treatment. This adverse event not infrequently leads to the reduction of treatment density and intensity. Existing papers report that low-grade B-NHL patients with HCV infection may have a more widespread disease, more frequent relapses or a lower ORR compared to HCV-negative patients. Notwithstanding that, there is no statistical evidence that the prognosis of HCV-positive patients is inferior to that of HCV-negative subjects. HCV-positive prospective studies and longer follow-up are necessary to ascertain if HCV-positive B-NHL patients have inferior outcomes and if there are long term sequels of immunochemotherapies on the progression of liver disease.

KEYWORDS:

Chemotherapy; Diffuse large B cell lymphoma; Hepatitis C virus; Hepatotoxicity; Immunochemotherapy; Marginal zone lymphoma; Non-Hodgkin’s lymphomas; Prognosis; Rituximab

PMID:
22468183
PMCID:
PMC3312928
DOI:
10.4251/wjgo.v4.i3.46
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