Hepatitis C virus infection is an independent prognostic factor in follicular lymphoma

Abstract

Hepatitis C virus (HCV) is a single-stranded RNA virus that not only affects hepatocytes, by B cells as well. It is thought that HCV is involved in the onset of B-cell lymphoma. The clinicopathological characteristics of HCV-positive diffuse large B-cell lymphoma (DLBCL) and HCV-positive splenic marginal zone lymphoma (SMZL) are known, but there has been no report on HCV-positive follicular lymphoma (FL). In this study, the clinicopathological characteristics of HCV-positive FL were examined in 263 patients with FL who were classified into a HCV-positive group with HCV antibody and negative groups without one. The number of patients with HCV-positive FL and HCV-negative FL was 10 (3.8%) and 253 (96.2%), respectively. The patients with HCV-positive FL commonly had more than one region of lymphadenopathy, Ann Arbor stage III/IV, hemoglobin <120 g/l, elevated lactate dehydrogenase level, and high-risk categorization of Follicular Lymphoma International Prognostic Index (FLIPI) than in patients with HCV-negative FL. Overall survival and progression-free survival were poorer in patients with HCV-positive FL than in those with HCV-negative FL (p < 0.0001 and 0.006, respectively). Also, multivariate analysis revealed that positive HCV antibody was a poor prognostic factor of OS. In conclusion, HCV-positive FL has unique clinical features and may have a great impact on the overall survival of affected patients.

Clinicopathologic characteristics of follicular lymphoma in hepatitis C virus‐infected patients

“…A recently reported study from Japan including 10 HCV‐infected patients with FL found that HCV‐infected patients had higher Ann Arbor stages, FLIPI scores, and number of lymph nodes involved compared to HCV‐uninfected patients with FL 19 . We did not find such differences in our study, possibly because our study was conducted in a tertiary cancer center, where patients with more advanced FL are typically referred.…”

“…In addition, we showed for the first time that A recently reported study from Japan including 10 HCV-infected patients with FL found that HCV-infected patients had higher Ann Arbor stages, FLIPI scores, and number of lymph nodes involved compared to HCV-uninfected patients with FL. 19 We did not find such differences in our study, possibly because our study was conducted in a tertiary cancer center, where patients with more advanced FL are typically referred. However, we did find that HCV-infected patients had a higher rate of splenic involvement of FL than HCV-uninfected patients had, in agreement with our previous studies showing a higher rate of splenic involvement in HCV-infected patients with DLBCL 20,21 and with earlier reports showing high rates of HCV seropositivity in patients with B-cell NHL involving the spleen.…”

Safe and effective treatment of follicular lymphoma in patients with HCV‐infection

“…9 Is HCV elimination associated with better outcome in FL patients is unclear and subject of discussion. The recent studies demonstrated that the HCV-positive vs HCV-negative FL patients had significantly worse outcome (3-year OS 40% vs 90%, P < .0001 and relapse-free survival 30% vs 60%, P = .006) 6 and HCV-infected patient with FL successfully treated had a better 10-year OS rate than did cases not treated with antivirals. 11 In our study, there were no HCV-untreated FL patients as a comparison (since this is impossible now due to curative treatment), but we did not find differences in survival in a comparable group of FL patients without HCV observed over the same…”

Combined Sofosbuvir/Daclatasvir and Chemotherapy Markedly Improve The Outcome of B-Lymphoid Malignancies in Patients with Both HCV Infection and B-Lymphoid Malignancy

“…Nesterova et al (31) found a non-significant difference in the outcome of 11 patients with FL and HCV infection who received sofosbuvir-based combination concomitant with immune-chemotherapy compared to patients with FL without HCV infection, which is the same in our study. The old studies demonstrated that the HCV-positive vs HCV-negative FL patients had significantly worse outcome (3-year OS 40% vs 90%, P < .0001 and relapse-free survival 30% vs 60%, P = .006) (35) . The only comparative study (31) conducted to compare the outcome of HCV positive lymphoid malignancies treated using DAAs concomitantly with chemotherapy versus HCV negative lymphoid malignancies had the same results as our study.…”