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

Occhipinti, Vincenzo; Farina, Lucia; Viganò, Mauro; Capecchi, Marco; Labanca, Sara; Fanetti, I.; Corradini, Paolo; Rumi, Maria Grazia

doi:10.1016/j.dld.2018.10.019

Cited by 14 publications

(17 citation statements)

References 48 publications

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“…Some studies showed that DAA treatment could reverse the liver inflammation, fibrosis, and decrease the complications of compensated liver cirrhosis in chronic hepatitis C [ 37 , 38 , 39 ]. From the observation report of Occhipinti et al, seven DLBCL patients with HCV infection received different DAA regimens concurrently with immunochemotherapy [ 40 ]. All patients completed their scheduled treatment with no liver toxicity occurrence.…”

Section: Discussionmentioning

confidence: 99%

Poor Prognosis of Diffuse Large B-Cell Lymphoma with Hepatitis C Infection

Tsai

Liu

Yang

et al. 2021

JPM

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Background: Hepatitis C virus (HCV) in diffuse large B-cell lymphoma (DLBCL) is associated with a higher prevalence and distinctive clinical characteristics and outcomes. Methods: A retrospective analysis of adult DLBCL patients from 2011 to 2015 was studied. Results: A total of 206 adult DLBCL were enrolled with 22 (10.7%) HCV-positive patients. Compared to HCV-negative patients, the HCV-positive group had a poor performance status (p = 0.011), lower platelet count (p = 0.029), and higher spleen and liver involvement incidences (liver involvement, p = 0.027, spleen involvement, p = 0.026), and they received fewer cycles of chemotherapy significantly due to morbidity and mortality (p = 0.048). Overall survival was shorter in HCV-positive DLBCL (25.3 months in HCV-positive vs. not reached (NR), p = 0.049). With multivariate analysis, poor performance status (p < 0.001), advanced stage (p < 0.001), less chemotherapy cycles (p < 0.001), and the presence of liver toxicity (p = 0.001) contributed to poor OS in DLBCL. Among HCV-positive DLBCL, the severity of liver fibrosis was the main risk factor related to death. Conclusion: Inferior survival of HCV-positive DLBCL was observed and associated with poor performance status, higher numbers of complications, and intolerance of treatment, leading to fewer therapy. Therefore, anti-HCV therapy, such as direct-acting antiviral agents, might benefit these patients in the future.

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Section: Discussionmentioning

confidence: 99%

Poor Prognosis of Diffuse Large B-Cell Lymphoma with Hepatitis C Infection

Tsai

Liu

Yang

et al. 2021

JPM

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“…Importantly, after HCV clearance by DAA therapy, only a small fraction of patients achieve a complete or partial response in both low-and high-grade lymphomas. However, a few months after the conclusion of antiviral treatment, a significant rate of relapse or progression of the hematological disease is observed, and these patients required immuno-or immunochemotherapy [37,[40][41][42][43][44][45]. MZL, marginal-zone lymphoma; DLBCL, diffuse large B-cell lymphoma; LLC, chronic lymphocityc leukemia; FL, follicular lymphoma; LPL, lymphoplasmocytic lymphoma; SOF, sofosbuvir; Other regimen: paritapreveir /ritonavir/ombitasvir+/-dasabuvir+/-ribavirin.…”

Section: Hcv and Non-hodgkin Lymphoma (Nhl)mentioning

confidence: 99%

A Review on Extrahepatic Manifestations of Chronic Hepatitis C Virus Infection and the Impact of Direct-Acting Antiviral Therapy

Mazzaro

Quartuccio

Adinolfi

et al. 2021

Viruses

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Extrahepatic manifestations are a feature of chronic hepatitis C virus (HCV) infection. In the course of chronic HCV infection, about 70% of patients have one or more extrahepatic manifestations. The latter are often the first and only clinical sign of infection. Experimental and clinical data support a causal association for many extrahepatic manifestations and HCV infection, which include mixed cryoglobulinemia, non-Hodgkin lymphomas (NHL), cardiovascular disease, insulin resistance, type 2 diabetes, neurological and psychiatric disease and other rheumatic diseases. All these extrahepatic conditions influence the morbidity, quality of life and mortality of HCV-infected patients. Currently, interferon-free therapeutic regimens with direct-acting antiviral agents (DAA) offer the possibility of treatment to almost the entire infected population, irrespective of stage of cirrhosis and associated serious comorbidities, always maintaining a high efficacy and tolerability. Several studies have shown a close association between HCV clearance by DAAs and an improvement or reduction in the risk of extrahepatic manifestations. Patients with HCV after a sustained virologic response (SVR) by DAA treatment have a lower risk than non-responders of developing cryoglobulinemic vasculitis and B-cell non-Hodgkin’s lymphomas. Furthermore, the SVR by DAA also reduces the risk of acute coronary syndrome, cardiovascular disease, insulin resistance and type 2 diabetes, and it improves atherosclerosis. HCV clearance by DAA also improves the quality of life and survival of patients with chronic HCV infection with associated extrahepatic diseases. Thus, DAAs should be initiated as early as possible in HCV patients with extrahepatic manifestations.

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“…In all studies, the SVR ranged from 100 to 82%, and the lymphoma response was outstanding (CR ranged from 100 to 82%). This great outcome persisted even after follow-up spanning from 9 to 34 months (25)(26)(27)(28)(29)(30)(31) .…”

Section: Daas Combined With Chemotherapy In Lymphoma Treatmentmentioning

confidence: 89%

“…Until now, only 7 studies examined the effect of DAAs given concurrently with chemotherapy in patients with different types of lymphoid malignancies and HCV infection (25)(26)(27)(28)(29)(30)(31) . Most of these studies are retrospective studies with only 1 prospective study (25) .…”

Section: Daas Combined With Chemotherapy In Lymphoma Treatmentmentioning

confidence: 99%

Lymphoid Malignancies and Direct-Acting Antivirals: Review Article

soliman

Zaghloul²,

Ali³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Hepatotropic virus HCV, which can infect hepatocytes, is also lymphotropic and can infect lymphocytes as well. Epidemiological, clinical, and biological evidence suggests that the pathogenesis of at least a portion of B-cell non-Hodgkin lymphomas (NHLs) are related to HCV infection. In the last six years, the approval of the new IFN-free antiviral treatment (AVT) with DAAs revolutionized the treatment of chronic HCV infection and many studies show improvement of lymphoid malignancies associated with HCV infection upon the use of direct-acting antivirals (DAAs). DAAs alone can improve indolent lymphomas and DAAs combined with chemotherapy improve the outcome of more aggressive lymphomas as many studies show that patients with HCV infection and lymphoid malignancies usually presented with a higher stage, have a higher frequency of extranodal presentation and a lower response rate (RR), disease free survival (DFS), and overall survival (OS) compared with other patients with lymphoid malignancies without HCV infection. Moreover, a number of lymphoid malignancies had reported soon after DAAs treatment for HCV infection. This is a systematic review of DAAs and their effect on lymphoid malignancies when given either combined or without chemotherapy. In addition, the review contains all cases reported before for the development of lymphoid malignancies after DAAs treatment for HCV infection.

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

Cited by 14 publications

References 48 publications

Poor Prognosis of Diffuse Large B-Cell Lymphoma with Hepatitis C Infection

Poor Prognosis of Diffuse Large B-Cell Lymphoma with Hepatitis C Infection

A Review on Extrahepatic Manifestations of Chronic Hepatitis C Virus Infection and the Impact of Direct-Acting Antiviral Therapy

Lymphoid Malignancies and Direct-Acting Antivirals: Review Article

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