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

Author:

Tsai Yu-Fen,Liu Yi-Chang,Yang Ching-I,Chuang Tzer-MingORCID,Ke Ya-Lun,Yeh Tsung-JangORCID,Gau Yuh-Ching,Du Jeng-ShiunORCID,Wang Hui-ChingORCID,Cho Shih-Feng,Hsu Chin-MuORCID,Wu Pey-Fang,Huang Ching-I,Huang Chung-Feng,Yu Ming-LungORCID,Dai Chia-YenORCID,Hsiao Hui-Hua

Abstract

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.

Funder

Kaohsiung Medical University Hospital

Publisher

MDPI AG

Subject

Medicine (miscellaneous)

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