Pb2014 Interferon-Free Antiviral Therapy in the Treatment of Relapse Hepatitis C Virus Associated Marginal Zone Lymphoma

Abstract

Analysis was made of the demographic characteristics, initial hematological and biochemical parameters, splenectomy history, presence of organomegaly and LAP, bone marrow (BM) fibrosis, and the clinical and biological presentation at the time of HCL diagnosis.BM biopsy was performed at 3-6 months after cladribine treatment for response evaluation. Results: The total 65 HCL patients comprised 47 (72.2%) males and 18 (27.3%) females with a median age of 53.6 years (range, 34-80 years). The median follow-up duration was 62.8 months (range: 5.7-229.3 months). Splenectomy was determined in the medical history of 2 patients with an unknown etiology.Cladribine monotherapy was administered as first-line treatment in 60 patients (92.3%), and 5 patients (7.7%) who did not meet the treatment criteria were followed up without treatment. Of the treated patients, CR was achieved in 54 patients (90%), and PR was achieved in 3 patients (5%) with the overall response rate (CR+PR) of 95%. SD was determined in the remaining 3 patients (5%) after first-line therapy. A total of 16 (24.4 %) patients either relapsed or progressed, with a median progression-free survival of 47 months (25-112 months). The analysis results showed that patients with relapse or progressive disease had higher LDH levels at the time of diagnosis than patients without relapse or progression (p:0.01).With the exception of lactate dehydrogenase (LDH) level at diagnosis, no significant difference was determined between these groups in respect of spleen and liver size, peripheral LAP, BM fibrosis score, hematological parameters, vitamin B12, ferritin levels, sedimentation and flow cytometric results Summary/Conclusion: This study demonstrated that an initial elevated LDH level is associated with a worse outcome in HCL patients. Patients with higher LDH levels may experience relapse or progression more frequently, therefore, the LDH level should be taken into account when deciding on treatment and those patients should be monitored more carefully. Aggressive treatment approaches such as combination therapies with monoclonal antibodies and PA may be considered as induction treatment. LDH level can be recommended for use as an inexpensive and easily available biomarker for risk assessment of HCL patients at onset.