Abstract
Chronic hepatitis C virus (HCV) infection is related with an increased risk of non-Hodgkin lymphomas (NHL). In indolent subtypes, regression of NHL was reported after HCV eradication with antiviral therapy (AT). In 2008 in Lombardy, a region of Northern Italy, the “Rete Ematologica Lombarda” (REL, Hematology Network of Lombardy—Lymphoma Workgroup) started a prospective multicenter observational cohort study on NHL associated with HCV infection, named “Registro Lombardo dei Linfomi HCV-positivi” (“Lombardy Registry of HCV-associated non-Hodgkin lymphomas”). Two hundred fifty patients with a first diagnosis of NHL associated with HCV infection were enrolled; also in our cohort, diffuse large B cell lymphoma (DLBCL) and marginal zone lymphoma (MZL) are the two most frequent HCV-associated lymphomas. Two thirds of patients had HCV-positivity detection before NHL; overall, NHL was diagnosed after a median time of 11 years since HCV survey. Our data on eradication of HCV infection were collected prior the recent introduction of the direct-acting antivirals (DAAs) therapy. Sixteen patients with indolent NHL treated with interferon-based AT as first line anti-lymphoma therapy, because of the absence of criteria for an immediate conventional treatment for lymphoma, had an overall response rate of 90%. After a median follow-up of 7 years, the overall survival (OS) was significantly longer in indolent NHL treated with AT as first line (P = 0.048); this confirms a favorable outcome in this subset. Liver toxicity was an important adverse event after a conventional treatment in 20% of all patients, in particular among DLBCL, in which it is more frequent the coexistence of a more advanced liver disease. Overall, HCV infection should be consider as an important co-pathology in the treatment of lymphomas and an interdisciplinary approach should be always considered, in particular to evaluate the presence of fibrosis or necroinflammatory liver disease.
| Original language | English |
|---|---|
| Journal | Hematological Oncology |
| DOIs | |
| Publication status | Published - Jan 1 2019 |
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Keywords
- antiviral therapy
- chronic hepatitis C virus infection
- cohort study
- non-Hodgkin lymphomas
ASJC Scopus subject areas
- Hematology
- Oncology
- Cancer Research
Cite this
Lymphomas associated with chronic hepatitis C virus infection : A prospective multicenter cohort study from the Rete Ematologica Lombarda (REL) clinical network. / on behalf of the “Rete Ematologica Lombarda” (REL - Hematology Clinical Network of Lombardy - Lymphoma Workgroup).
In: Hematological Oncology, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Lymphomas associated with chronic hepatitis C virus infection
T2 - A prospective multicenter cohort study from the Rete Ematologica Lombarda (REL) clinical network
AU - on behalf of the “Rete Ematologica Lombarda” (REL - Hematology Clinical Network of Lombardy - Lymphoma Workgroup)
AU - Rattotti, Sara
AU - Ferretti, Virginia Valeria
AU - Rusconi, Chiara
AU - Rossi, Andrea
AU - Fogazzi, Stefano
AU - Baldini, Luca
AU - Pioltelli, Pietro
AU - Balzarotti, Monica
AU - Farina, Lucia
AU - Ferreri, Andrés J.M.
AU - Laszlo, Daniele
AU - Speziale, Valentina
AU - Varettoni, Marzia
AU - Sciarra, Roberta
AU - Morello, Lucia
AU - Tedeschi, Alessandra
AU - Frigeni, Marco
AU - Defrancesco, Irene
AU - Zerbi, Caterina
AU - Flospergher, Elena
AU - Nizzoli, Maria Elena
AU - Morra, Enrica
AU - Arcaini, Luca
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Chronic hepatitis C virus (HCV) infection is related with an increased risk of non-Hodgkin lymphomas (NHL). In indolent subtypes, regression of NHL was reported after HCV eradication with antiviral therapy (AT). In 2008 in Lombardy, a region of Northern Italy, the “Rete Ematologica Lombarda” (REL, Hematology Network of Lombardy—Lymphoma Workgroup) started a prospective multicenter observational cohort study on NHL associated with HCV infection, named “Registro Lombardo dei Linfomi HCV-positivi” (“Lombardy Registry of HCV-associated non-Hodgkin lymphomas”). Two hundred fifty patients with a first diagnosis of NHL associated with HCV infection were enrolled; also in our cohort, diffuse large B cell lymphoma (DLBCL) and marginal zone lymphoma (MZL) are the two most frequent HCV-associated lymphomas. Two thirds of patients had HCV-positivity detection before NHL; overall, NHL was diagnosed after a median time of 11 years since HCV survey. Our data on eradication of HCV infection were collected prior the recent introduction of the direct-acting antivirals (DAAs) therapy. Sixteen patients with indolent NHL treated with interferon-based AT as first line anti-lymphoma therapy, because of the absence of criteria for an immediate conventional treatment for lymphoma, had an overall response rate of 90%. After a median follow-up of 7 years, the overall survival (OS) was significantly longer in indolent NHL treated with AT as first line (P = 0.048); this confirms a favorable outcome in this subset. Liver toxicity was an important adverse event after a conventional treatment in 20% of all patients, in particular among DLBCL, in which it is more frequent the coexistence of a more advanced liver disease. Overall, HCV infection should be consider as an important co-pathology in the treatment of lymphomas and an interdisciplinary approach should be always considered, in particular to evaluate the presence of fibrosis or necroinflammatory liver disease.
AB - Chronic hepatitis C virus (HCV) infection is related with an increased risk of non-Hodgkin lymphomas (NHL). In indolent subtypes, regression of NHL was reported after HCV eradication with antiviral therapy (AT). In 2008 in Lombardy, a region of Northern Italy, the “Rete Ematologica Lombarda” (REL, Hematology Network of Lombardy—Lymphoma Workgroup) started a prospective multicenter observational cohort study on NHL associated with HCV infection, named “Registro Lombardo dei Linfomi HCV-positivi” (“Lombardy Registry of HCV-associated non-Hodgkin lymphomas”). Two hundred fifty patients with a first diagnosis of NHL associated with HCV infection were enrolled; also in our cohort, diffuse large B cell lymphoma (DLBCL) and marginal zone lymphoma (MZL) are the two most frequent HCV-associated lymphomas. Two thirds of patients had HCV-positivity detection before NHL; overall, NHL was diagnosed after a median time of 11 years since HCV survey. Our data on eradication of HCV infection were collected prior the recent introduction of the direct-acting antivirals (DAAs) therapy. Sixteen patients with indolent NHL treated with interferon-based AT as first line anti-lymphoma therapy, because of the absence of criteria for an immediate conventional treatment for lymphoma, had an overall response rate of 90%. After a median follow-up of 7 years, the overall survival (OS) was significantly longer in indolent NHL treated with AT as first line (P = 0.048); this confirms a favorable outcome in this subset. Liver toxicity was an important adverse event after a conventional treatment in 20% of all patients, in particular among DLBCL, in which it is more frequent the coexistence of a more advanced liver disease. Overall, HCV infection should be consider as an important co-pathology in the treatment of lymphomas and an interdisciplinary approach should be always considered, in particular to evaluate the presence of fibrosis or necroinflammatory liver disease.
KW - antiviral therapy
KW - chronic hepatitis C virus infection
KW - cohort study
KW - non-Hodgkin lymphomas
UR - http://www.scopus.com/inward/record.url?scp=85061962957&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85061962957&partnerID=8YFLogxK
U2 - 10.1002/hon.2575
DO - 10.1002/hon.2575
M3 - Article
JO - Hematological Oncology
JF - Hematological Oncology
SN - 0278-0232
ER -