Interferon-free antiviral treatment in B-cell lymphoproliferative disorders associated with hepatitis C virus infection

Luca Arcaini, Caroline Besson, Marco Frigeni, Hélène Fontaine, Maria Goldaniga, Milvia Casato, Marcella Visentini, Harrys A. Torres, Veronique Loustaud-Ratti, Jan Peveling-Oberhag, Paolo Fabris, Roberto Rossotti, Francesco Zaja, Luigi Rigacci, Sara Rattotti, Raffaele Bruno, Michele Merli, Céline Dorival, Laurent Alric, Arnaud JaccardStanislas Pol, Fabrice Carrat, Virginia Valeria Ferretti, Carlo Visco, Olivier Hermine

Research output: Contribution to journalArticle

Abstract

Regression of hepatitis C virus (HCV)-associated lymphoma with interferon (IFN)-based antiviral treatment supports an etiological link between lymphoma and HCV infection. In addition, a favorable impact of antiviral treatment on overall survival of patients with HCV-related lymphoma has been reported. Data on IFN-free regimens combining direct-acting antivirals (DAAs) in HCV-associated lymphoproliferative disorders are scanty. We analyzed the virological and lymphoproliferative disease response (LDR) of 46 patients with indolent B-cell non-Hodgkin lymphomas (NHLs) or chronic lymphocytic leukemia (CLL) and chronic HCV infection treated with DAAs. The histological distribution was 37 marginal zone lymphomas (MZLs), 2 lymphoplasmacytic lymphomas, 2 follicular lymphomas, 4 CLL/small lymphocytic lymphomas (CLL/SLLs), and 1 low-grade NHL not otherwise specified. Thirty-nine patients received a sofosbuvir-based regimen and 7 patients received other DAAs. The median duration of DAA therapy was 12 weeks (range, 6-24 weeks). A sustained virological response at week 12 after finishing DAAs was obtained in 45 patients (98%); the overall LDR rate was 67%, including 12 patients (26%) who achieved a complete response. The LDR rate was 73% among patients with MZL, whereas no response was observed in CLL/SLL patients. Seven patients cleared cryoglobulins out of 15 who were initially positive. After a median follow-up of 8 months, 1-year progression-free and overall survival rates were 75% (95% confidence interval [CI], 51-88] and 98% [95% CI, 86-100], respectively. DAA therapy induces a high LDR rate in HCV-associated indolent lymphomas. These data provide a strong rationale for prospective trials with DAAs in this setting.

Original languageEnglish
Pages (from-to)2527-2532
Number of pages6
JournalBlood
Volume128
Issue number21
DOIs
Publication statusPublished - Nov 24 2016

Keywords

  • Journal Article

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    Arcaini, L., Besson, C., Frigeni, M., Fontaine, H., Goldaniga, M., Casato, M., Visentini, M., Torres, H. A., Loustaud-Ratti, V., Peveling-Oberhag, J., Fabris, P., Rossotti, R., Zaja, F., Rigacci, L., Rattotti, S., Bruno, R., Merli, M., Dorival, C., Alric, L., ... Hermine, O. (2016). Interferon-free antiviral treatment in B-cell lymphoproliferative disorders associated with hepatitis C virus infection. Blood, 128(21), 2527-2532. https://doi.org/10.1182/blood-2016-05-714667