Concomitant therapy with direct-acting antivirals and chemoimmunotherapy in HCV-associated diffuse large B-cell lymphoma

Vincenzo Occhipinti, Lucia Farina, Mauro Viganò, Marco Capecchi, Sara Labanca, Ilaria Fanetti, Paolo Corradini, Mariagrazia Rumi

Research output: Contribution to journalArticle

Abstract

Introduction: The association between hepatitis C virus (HCV) infection and B-cell non-Hodgkin's Lymphomas (NHL) is well established. Antiviral therapy (AVT) is the first-line treatment for HCV-related indolent NHL whereas diffuse large B-cell lymphoma (DLBCL) requires immediate start of chemoimmunotherapy (CIT), usually deferring AVT. However, an early HCV elimination may reduce the risk of CIT-induced liver toxicity and consequent CIT interruption or withdrawal. To date few data are available on safety and efficacy of concomitant administration of direct-acting antivirals (DAA) and CIT in HCV-associated DLBCL. Methods: 7 consecutive patients (5 males, median age 65 years) with HCV infection (four genotype 2a/2c, two genotype 1b, one genotype 4; one patient with compensated cirrhosis) and DLBCL received different DAA regimens concurrently with CIT. Results: All patients completed the scheduled AVT and CIT with neither interruption nor withdrawal of the latter. One case of neutropenia was observed during concomitant therapy, no liver toxicity occurred. All patients achieved sustained virological response and complete DLBCL response (median follow-up of 12 months). Conclusions: Concomitant administration of DAA and CIT for HCV-associated DLBCL is safe and may prevent CIT-induced liver toxicity. Large, prospective studies are needed to confirm these preliminary data and to assess prognostic implications.

Original languageEnglish
Pages (from-to)719-723
Number of pages5
JournalDigestive and Liver Disease
Volume51
Issue number5
DOIs
Publication statusPublished - May 2019

Keywords

  • Chemoimmunotherapy
  • Diffuse large B-cell lymphoma
  • Direct-acting antivirals
  • Hepatitis C virus
  • Rituximab
  • Safety

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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