Impact of treatment-related liver toxicity on the outcome of HCV-positive non-Hodgkin's lymphomas

Luca Arcaini, Michele Merli, Francesco Passamonti, Raffaele Bruno, Ercole Brusamolino, Paolo Sacchi, Sara Rattotti, Ester Orlandi, Elisa Rumi, Virginia Ferretti, Silvia Rizzi, Erika Meli, Cristiana Pascutto, Marco Paulli, Mario Lazzarino

Research output: Contribution to journalArticlepeer-review

Abstract

We studied 160 Hepatitis C virus (HCV)-positive patients with NHL (59 indolent NHL, 101 aggressive). Median age was 67 years. HCV-RNA was present in 146. HBsAg was positive in seven patients. At diagnosis, ALT value was above UNL in 67 patients. One hundred and twenty patients received an anthracycline-based therapy, alkylators, 28 received chemotherapy plus rituximab. Cytotoxic drugs dose was reduced in 63 patients. Among 93 patients with normal ALT at presentation, 16 patients developed WHO grade II-III liver toxicity. Among 67 patients with abnormal ALT, eight patients had a 3.5 times elevation during treatment. Among 28 patients treated with rituximab and chemotherapy, five patients (18%) developed liver toxicity. Thirty four patients (21%) did not complete treatment (eight for liver toxicity). Median progression-free survival (PFS) for patients who experienced liver toxicity is significantly shorter than median PFS of patients without toxicity (respectively, 2 years and 3.7 years, P = 0.03). After a median F-UP of 2 years, 32 patients died (three for hepatic failure). A significant proportion of patients with HCV + NHL develop liver toxicity often leading to interruption of treatment. This could be a limit to the application of immunochemotherapy programs. HCV+ lymphomas represent a distinct clinical subset of NHL that deserves specific clinical approach to limit liver toxicity and ameliorate survival.

Original languageEnglish
Pages (from-to)46-50
Number of pages5
JournalAmerican Journal of Hematology
Volume85
Issue number1
DOIs
Publication statusPublished - Jan 2010

ASJC Scopus subject areas

  • Hematology

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