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Ann Oncol. 2014 Jul;25(7):1404-10. doi: 10.1093/annonc/mdu166. Epub 2014 May 5.

Antiviral treatment in patients with indolent B-cell lymphomas associated with HCV infection: a study of the Fondazione Italiana Linfomi.

Author information

1
Department of Molecular Medicine, University of Pavia, Pavia Department of Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia.
2
Division of Hematology, Ospedale Giovanni da Saliceto, Piacenza.
3
Department of Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia.
4
Unit of Lymphoid Malignancies, San Raffaele Scientific Institute, Milano.
5
Division of Hematology, Department of Internal Medicine, Ospedale di Circolo, Fondazione Macchi, Varese.
6
Division of Hematology 2, AO S Giovanni Battista, Torino.
7
Department of Medicine, Section of Hematology, University of Verona, Verona.
8
Division of Hematology, Spedali Civili, Brescia.
9
Division of Hematology, Ospedale Niguarda Ca' Granda, Milano.
10
Division of Hematology, Ospedale San Bortolo, Vicenza.
11
Division of Medical Oncology, National Cancer Center, Aviano.
12
Division of Hematology, Osp A Businco, Cagliari.
13
Department of Oncology and Hematology, University of Modena and Reggio Emilia, Modena.
14
IMO, Department of Internal Medicine and Clinical Oncology, University of Bari, Aldo Moro, Bari.
15
Scientific Direction, IRCCS, Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture.
16
Division of Hematology, Department of Experimental Medicine and Oncology, University of Torino, Torino.
17
Hematology Unit, Department of Oncology, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia.
18
Division of Hematology, Dipartimento di Ematologia, Ospedale M. Morelli, Reggio Calabria.
19
Division of Oncohematology, Ospedale Umberto I, Nocera Inferiore.
20
Division of Hematology, Azienda Ospedaliero Universitaria Careggi, Firenze.
21
Division of Hematology, Azienda Ospedaliera SS Arrigo e Biagio e Cesare Arrigo, Alessandria.
22
Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara.
23
Division of Haematology, Hospital of Cremona, Cremona.
24
Division of Hematology, Policlinico, Palermo.
25
Department of Oncology, Istituto Oncologico Veneto, IRCCS, Padova.
26
Division of Infectious and Tropical Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia.
27
Division of Hematology, Fondazione IRCCS Cà Granda OM Policlinico, Università degli Studi, Milano.
28
Division of Hematology, Sapienza University, Rome, Italy.

Abstract

BACKGROUND:

Tumor regression after antiviral therapy (AT) is in favor of an etiological role of hepatitis C virus (HCV) in non-Hodgkin's B-cell lymphomas (NHL).

PATIENTS AND METHODS:

We carried out a cohort study of 704 consecutive HIV-negative, HCV-positive patients with indolent NHL diagnosed and treated from 1993 to 2009 in 39 centers of the Fondazione Italiana Linfomi; 134 patients were managed with AT for lymphoma control.

RESULTS:

For entire cohort, 5-year overall survival (OS) was 78% [95% confidence interval (CI): 74%-82%] and 5-year progression-free survival (PFS) was 48% (95% CI: 44%-53%). In multivariate analysis, the use of AT during the patients' life had positive impact on OS. Forty-four of the 100 patients treated with first-line AT achieved a complete remission (CR) and 33 a partial response (PR). HCV-RNA clearance was achieved in 80 patients and was related to lymphoma response. At a median follow-up of 3.6 years, 5-year PFS was 63% (95% CI: 50%-73%). CR + PR rate was 85% with AT as second-line treatment.

CONCLUSION:

AT produces HCV-RNA clearance and consequent tumor regression in most patients with HCV-related indolent NHL. AT used at any time is associated with improved OS. Consequently, AT can be considered an option for patients with indolent lymphomas who do not need immediate cytoreductive treatment.

KEYWORDS:

HCV; antiviral treatment; indolent lymphoma; outcome

PMID:
24799461
DOI:
10.1093/annonc/mdu166
[Indexed for MEDLINE]

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